Practice of venous thromboembolism (VTE) prophylaxis in hospitalized cancer patients at a comprehensive cancer center.

Authors

Maria Rodriguez

Maria Rodriguez

The University of Texas MD Anderson Cancer Center

Maria Rodriguez, Alma Yvette DeJesus, Lee Cheng, Michael Kroll

Organizations

The University of Texas MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

No funding sources reported

Background: VTE prophylaxis measures are endorsed by the National Quality Forum in alignment with quality indicators from the Centers for Medicare & Medicaid Services. Accordingly, documentation of VTE risk, prophylaxis measures, and contraindications are recommended for hospitalized patients. To standardize practice we embedded a VTE risk assessment and prophylaxis module into admission and post-surgical order sets (OS), starting August 15, 2011. Methods: A retrospective study of 9,065 cancer patients (≥18 years) admitted to The University of Texas MD Anderson Cancer Center between June 01, 2013 through September 30, 2013. Pharmacological prophylaxis was executed with low-molecular-weight heparin or unfractionated heparin. Mechanical prophylaxis was executed with graduated compression stockings and/or sequential compression devices. Chi-square testing was used to determine the association between categorical variables. All statistically significant levels were determined with P values < 0.05. Results: 7,366 (81%) of all hospital admissions had documented VTE risk assessment and prophylaxis through the standardized VTE module. Before implementation of the new OS, only 40% of eligible patients received an order for VTE prophylaxis. The majority of patients were designated high or moderate risk (91.1%). Patients with high risk were more likely to receive pharmacological prophylaxis than those with moderate risk (74.1% vs. 38.2%, P<0.01). The most frequent contraindications to pharmacological prophylaxis were major surgery with risk of bleeding and thrombocytopenia (Table). Conclusions: Most patients received VTE prophylaxis based on VTE risk levels presented in a standardized OS. There is is limited information in the clinical literature about the impact of VTE prophylaxis on outcomes among cancer patients, we plan to assess anticoagulation-related outcomes in this cohort of patients.

VTE risk sssessment and prophylaxis (n=7,366).
Risk level No (%) % of frequency distribution of prophylaxis
Pharmacological Pharmocological contraindication Mechanical
High 1,021 (13.9%) 74.1 20.1 99.7
Moderate 5,689 (77.2%) 38.2 56.3 35.4
Low 656 (8.9%) N/A N/A 97.6

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2014 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

General Poster Session B: Cost, Value, and Policy in Quality and Practice of Quality

Track

Practice of Quality,Cost, Value, and Policy in Quality

Sub Track

Patient Safety

Citation

J Clin Oncol 32, 2014 (suppl 30; abstr 149)

DOI

10.1200/jco.2014.32.30_suppl.149

Abstract #

149

Poster Bd #

F17

Abstract Disclosures

Similar Abstracts

First Author: Maria Alma Rodriguez

First Author: Hannah Dysinger McLaughlin