Method of Study.
The method of study was conducted through quantitative research, data was analyzed from patients admitted to the hospital from the year 2005 to 2007 with a primary diagnosis of chronic heart failure, thromboembolic stroke, severe lung disease, acute infection, or cancer, according to whether they received VTE prophylaxis or not. VTE pharmacologic prophylaxis included low molecular weight heparin, warfarin, unfractionated heparin, and fondaparinux. The number of VTE events, time to VTE event, length of hospital stay, and number of major or minor bleeding events were analyzed from the index date until the end of follow-up (180 days post discharge) or death. Data from 172 hospitals were identifiable for linkage in both hospital and claims databases and covered a geographically diverse area and both public and private health plans. These databases capture clinical and prescription data for the full continuum of care, including physician office visits; hospital stays; retail, mail order, and specialty pharmacies. The population was grouped into 2 cohorts: those who developed VTE during index hospitalization and those who did not. VTE during hospitalization was identified by the presence of ICD-9 codes for deep vein thrombosis or pulmonary embolism on hospital records. In order to ensure that patients were not erroneously designated as having VTE, true VTE was defined as any VTE event for which anticoagulant therapy was prescribed within 15 days of diagnosis.
Results of Study.
Overall, 7127 of 13,293 patients (53.6%) received VTE prophylaxis. Prophylaxis significantly reduced the incidence of VTE compared with no prophylaxis (0.06% vs 3.44%, respectively; P <.00001) and increased the median time to VTE (182 vs 27 days, respectively). Prophylaxis also significantly reduced the incidence of VTE in the 180 days post discharge. Readmission rates were similar between groups. Major bleeding occurred in 1.