title: Common characteristics of patients diagnosed with upper-extremity venous thromboembolism during hospitalization: a descriptive study.
abstract: OBJECTIVE
  The aim of this study was to explore the common characteristics of patients diagnosed with upper-extremity venous thromboembolism (UEVTE) during hospitalization.
  
  
  METHODS
  This was a retrospective chart review.
  
  
  METHODS
  This study was performed at a Midwest multisite hospital of 5 acute-care hospitals and 2051 beds.
  
  
  METHODS
  The sample was composed of 777 hospitalized adult patients who had a positive upper-extremity venous Doppler from July 2008 to July 2009.
  
  
  RESULTS
  Patients were adults with a mean age of 66.6 (SD, 17.0) years and mean hospital stay of 15.7 (SD, 12.4) days. When assessing the arm clots, 398 patients (51.2%) had a right arm clot, 317 patients (40.8%) had a left arm clot, and 62 patients (8.0%) had clots in both arms. Patients were primarily admitted with medical conditions, and more than one-half were overweight or obese (59.2%). Nearly 50% of patients were at the highest venous thromboembolism (VTE) risk upon admission (n = 362), were tobacco users (n = 379), and had surgeries or invasive procedures performed prior to upper-extremity venous Doppler (n = 395). In 58.6% of the patients, chemoprophylaxis through intravenous anticoagulation therapy was administered during the first 3 days of admission. In patients with an intravenous catheter in an arm, UEVTE was likely to occur in the same arm (right and left arm, P < .001).
  
  
  CONCLUSIONS
  Nurses caring for patients with characteristics commonly found in cases of UEVTE should regularly monitor the arms of their patients and communicate findings in shift reports to heighten awareness of UEVTE risk. In addition, patients with medical diagnoses that prevent use of early anticoagulation for VTE prophylaxis such as gastrointestinal bleed, hematologic disorders, trauma, and hemorrhagic strokes should be frequently assessed for UEVTE. Learning the characteristics of patients who had UEVTE during their hospitalization and the role of early and late anticoagulation in the development of UEVTE would advance nurse assessment and lead to novel interventions and future research.
authors.affiliation: Author Affiliations: Clinical Development Specialist (Ms Watts) and Manager (Dr Sulo), Patient-Centered Outcomes Research Russell Institute for Research & Innovation Center for Advanced Care, Advocate Health Care, Oak Brook; Clinical Nurse Specialists (Mss Kuehnlenz, Eckhouse, and Benson), Advocate Lutheran General Hospital, Park Ridge; Clinical Nurse Specialist (Ms Connell), Advocate Trinity Hospital, Chicago; Clinical Nurse Specialist (Ms Dailey), Advocate Good Samaritan Hospital, Downers Grove; Clinical Nurse Specialists (Mss Ellis and Ong), Advocate Christ Medical Center, Oak Lawn; Clinical Nurse Specialists (Mss Jorgensen and Minga), Advocate South Suburban Hospital, Hazel Crest; and Clinical Coordinator (Ms Sroka), Advocate Good Shepherd Hospital, Barrington, Illinois.
authors.forename: Joanne LaMantia
authors.initials: JL
authors.lastname: Watts
authors.forename: Diane
authors.initials: D
authors.lastname: Kuehnlenz
authors.forename: Suela
authors.initials: S
authors.lastname: Sulo
authors.forename: Euphemia
authors.initials: E
authors.lastname: Connell
authors.forename: Mary Sue
authors.initials: MS
authors.lastname: Dailey
authors.forename: Diane
authors.initials: D
authors.lastname: Eckhouse
authors.forename: Donna
authors.initials: D
authors.lastname: Ellis
authors.forename: Ann
authors.initials: A
authors.lastname: Jorgensen
authors.forename: Gina
authors.initials: G
authors.lastname: Minga
authors.forename: Fely
authors.initials: F
authors.lastname: Ong
authors.forename: Linda
authors.initials: L
authors.lastname: Sroka
authors.forename: Irene
authors.initials: I
authors.lastname: Benson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009730:Nursing Assessment; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D034941:Upper Extremity / Q000098:blood supply*; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000451:nursing
chemical_list: D000925:Anticoagulants