R. Lecumberri (1), M. Marqués (2), E. Panizo (1), A. Alfonso (1), A. García-Mouriz (3), I. Gil-Bazo (4), J. Hermida (5), S. Schulman (6), J. A. Páramo (1)
(1) Hematology Service, University Clinic of Navarra, Pamplona, Spain; (2) Documentation Service, University Clinic of Navarra, Pamplona, Spain; (3) Informatics Service, University Clinicof Navarra, Pamplona, Spain; (4) Oncology Department, University Clinic of Navarra, Pamplona, Spain; (5) Division of Cardiovascular Sciences, Centre of Applied Medical Research, University of Navarra, Pamplona, Spain; (6) Department of Medicine, McMaster University, Hamilton, Ontario, Canada
cancer, venous thromboembolism, prophylaxis, hospitalised patients, electronic alerts
Many cancer patients are at high risk of venous thromboembolism (VTE) during hospitalisation; nevertheless, thromboprophylaxis is frequently underused. Electronic alerts (e-alerts) have been associated with improvement in thromboprophylaxis use and a reduction of the incidence of VTE, both during hospitalisation and after discharge, particularly in the medical setting. However, there are no data regarding the benefit of this tool in cancer patients. Our aim was to evaluate the impact of a computer-alert system for VTE prevention in patients with cancer, particularly in those admitted to the Oncology/Haematology ward, comparing the results with the rest of inpatients at a university teaching hospital. The study included 32,167 adult patients hospitalised during the first semesters of years 2006 to 2010, 9,265 (28.8%) with an active malignancy. Appropriate prophylaxis in medical patients, significantly increased over time (from 40% in 2006 to 57% in 2010) and was maintained over 80% in surgical patients. However, while e-alerts were associated with a reduction of the incidence of VTE during hospitalisation in patients without cancer (odds ratio [OR] 0.31; 95% confidence interval [CI], 0.15–0.64), the impact was modest in cancer patients (OR 0.89; 95% CI, 0.42–1.86) and no benefit was observed in patients admitted to the Oncology/Haematology Departments (OR 1.11; 95% CI, 0.45–2.73). Interestingly, 60% of VTE episodes in cancer patients during recent years developed despite appropriate prophylaxis. Contrary to the impact on hospitalised patients without cancer, implementation of e-alerts for VTE risk did not prevent VTE effectively among those with malignancies.
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A. Matzdorff (1)
Phlebologie 2015 44 6: 299-303
Manuel Monreal 1, Luis Peidro 2, Carlos Resines 3, Carlos Garcés 4, José Luís Fernández 5, Eduardo Garagorri 6, Juan Carlos González 7, for the NETCOT Investigators*
Thromb Haemost 2008 99 6: 1112-1115
Federico Jorge Bottaro 1,3, Maria Cristina Elizondo 1, Carlos Doti 2,3, Julio Enrique Bruetman 1, Pablo Diego Perez Moreno 1, Eduardo Oscar Bullorsky 2,3, Jose Manuel Ceresetto2,3
Thromb Haemost 2008 99 6: 1104-1111