African American race was associated with an increased risk of complications following venous thromboembolism.
OBJECTIVE
Limited data exist on the quality of care for patients with venous thromboembolism (VTE), and it is unknown whether the processes and outcomes of care for this illness differ between African Americans and whites.


METHODS
We retrospectively studied 168 patients hospitalized for VTE in two Veterans Affairs hospitals during fiscal years 2000-2002. Patient characteristics, information about processes of care, and medical outcomes at 90 days after the index VTE event were abstracted from medical records. We used logistic regression to explore associations between race, processes of care, and the overall 90-day complication rate (i.e., death, bleeding, or recurrent VTE), adjusting for patient baseline characteristics.


RESULTS
Multivariable analysis demonstrated that administration of warfarin within 1 day of starting heparin (odds ratio [OR] 0.20, 95% confidence interval [CI]: 0.05-0.42) and overlap of heparin and warfarin treatment >or=4 days (OR 0.09, 95% CI: 0.02-0.50) were associated with a lower complication rate, and African American race was associated with a higher complication rate (OR 5.2, 95% CI: 1.3-21.6). Race was not significantly associated with the performance of processes of care in multivariable analysis.


CONCLUSIONS
Although African Americans had an increased risk of complications following VTE, race was not independently associated with the use of processes of care for VTE.
Aujesky
Drahomir
D
Division of Internal Medicine, the Clinical Epidemiology Center, University of Lausanne, Lausanne, Switzerland. drahomir.aujesky@chuv.ch
Long
Judith A
JA
Fine
Michael J
MJ
Ibrahim
Said A
SA
D001741:Black or African American; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000150:complications / Q000188:drug therapy / Q000208:ethnology*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000208:ethnology*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin