Prevention and clinical outcomes in older inpatients with suspected venous thromboembolism.
Venous thromboembolism (VTE) is one of the most common preventable disorders among hospital inpatients. Advancing age is a major risk factor for VTE. The purpose of this study was to describe and compare prevention practices and clinical outcomes in older (age 65 and older) versus younger (ages 18 to 64) hospitalized patients at risk for or diagnosed with VTE. Medical charts of 210 older and 450 younger inpatients undergoing diagnostic tests to rule out VTE were reviewed at an academic medical center. Acute VTE was diagnosed in 17.1% of older and 22.7% of younger inpatients. Pharmacological prophylaxis was used in 70% of eligible older and 57% of eligible younger inpatients. Nearly one quarter of eligible older inpatients did not receive any VTE prevention measures. The 3-month mortality was higher in older inpatients (13.9%) compared with younger inpatients (9.8%) with VTE, despite the lower rate of VTE in older inpatients. Prevention measures for VTE were underused in both older and younger inpatients.
Lee
Jung-Ah
JA
University of California-Irvine, College of Health Sciences, Program in Nursing Science, Irvine, California 92697-3959, USA. jungahl@uci.edu
Zierler
Brenda K
BK
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011322:Primary Prevention / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants