The use of pharmacological prophylaxis against venous thromboembolism in hospitalised patients with severe active ulcerative colitis

J. L. Pleet, B. P. Vaughn, J. A. Morris, A. C. Moss, A. S. Cheifetz

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background Hospitalised patients with inflammatory bowel disease are 1.5- to 3.5-fold more likely to develop venous thromboembolism compared to controls. Clinical guidelines recommend pharmacological prophylaxis. Aim To determine the rate of pharmacological venous thromboembolism prophylaxis prescription and administration in a cohort of hospitalised patients with severe active ulcerative colitis and to assess predictors of failure to order pharmacological prophylaxis at 24 h. Methods This is a retrospective review of hospitalised patients with severe active ulcerative colitis, identified by ICD-9-CM discharge code 556.x, admitted to a single tertiary care hospital from 1 January 2005 to 31 August 2012. Adequate thromboembolism prophylaxis was defined as an order for low-dose unfractionated heparin two to three times daily, low-molecular weight heparin 40 mg daily or fondaparinux 2.5 mg daily ordered and administered for >80% of the admission. Patient related factors associated with failure to order prophylaxis at 24 h were accessed as secondary outcomes. Results Three hundred and thirty-six patients were hospitalised with severe active ulcerative colitis. Hospitalists had prescribed appropriate pharmacological prophylaxis by 48 h in only 37% of cases. Of these, nurses administered all prescribed doses in 18% of cases. Only 7% of patients (22/304, 95% CI: 5-11%) received adequate pharmacological prophylaxis for >80% of their hospitalisation. Hematochezia (P = 0.002), elevated platelets (P = 0.008), male gender coupled with younger age (P = 0.005) and admission on a biologic (P = 0.03) were associated with failure to order prophylaxis. Conclusion Hospitalised patients admitted with severe active ulcerative colitis are not receiving appropriate pharmacological venous thromboembolism prophylaxis.

Original languageEnglish (US)
Pages (from-to)940-948
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume39
Issue number9
DOIs
StatePublished - May 2014

Fingerprint

Dive into the research topics of 'The use of pharmacological prophylaxis against venous thromboembolism in hospitalised patients with severe active ulcerative colitis'. Together they form a unique fingerprint.

Cite this