More Venous Thromboembolism Prophylaxis Needed in Heart Failure Patients: Presented at HFSA

To print: Select File and then Print from your browser's menu
---------------------------------------------------------------------------------------
Title: More Venous Thromboembolism Prophylaxis Needed in Heart Failure Patients: Presented at HFSA
URL: http://www.pslgroup.com/dg/22DA2A.htm
Doctor's Guide
September 26, 2008

By Jill Stein

TORONTO -- September 26, 2008 -- Researchers are calling for increased use of prophylaxis against venous thromboembolism (VTE) in congestive heart failure (CHF) patients based on study findings that show a low rate of heart failure patients receiving appropriate evidence-based VTE prophylaxis at hospital discharge.

The recommendation was issued by Alpesh Amin, MD, Department of Medicine, University of California, Irvine, Irvine, California, at the Heart Failure Society of America (HFSA) 12th Annual Scientific Meeting.

Dr. Amin and colleagues assessed the real-world rate of appropriate VTE prophylaxis in high-risk heart failure patients admitted to hospitals in the United States in accordance with the 7th (2004 update) American College of Chest Physicians (ACCP) guidelines.

Hospitalised patients with CHF have a 3-fold increased risk of VTE, Dr. Amin pointed out in a presentation on September 22. The 2004 and recently updated 2008 ACCP guidelines recommend that heart failure patients admitted to hospital receive VTE prophylaxis with low-molecular-weight heparin or low-dose unfractionated heparin. However, despite the availability of guidelines that recommend safe and effective VTE prophylaxis, the clinical burden of VTE in the United States remains high, he added.

The improvement of VTE prophylaxis practices in the United States is currently a major healthcare goal for the US Joint Commission, which recently released hospital performance initiatives to reduce the incidence of preventable VTE.

For their study, the researchers included 34,286 heart failure discharges in their analysis.

The study found that although 78.9% of heart failure patients discharged from hospital were prescribed a form of VTE prophylaxis, only 15.9% of heart failure discharges received appropriate evidence-based VTE prophylaxis.

"As discharges in this analysis required a length of stay of at least 6 days to meet the inclusion criteria, this result of 15.9% appropriate prophylaxis represents the practice pattern in a high-risk patient group," Dr. Amin noted.

The main reasons that heart failure discharges did not receive appropriate prophylaxis were inappropriate dose (22.1% of all discharges) or insufficient duration of prophylaxis (39.3% of all discharges).

The study also found that higher rates of appropriate prophylaxis were observed in teaching hospitals versus nonteaching hospitals and in urban versus rural hospitals. Further analyses are needed to determine whether this is due to differences in hospitals or patient characteristics.

"As US hospitals focus on VTE prophylaxis performance initiatives and performance measures, it is important that hospital personnel increase their awareness and use of appropriate VTE prophylaxis," Dr. Amin said.

Funding for the study was provided by sanofi-aventis.

[Presentation title: Examining the Rate of Appropriate, ACCP-Recommended VTE Prophylaxis Use in Heart Failure Patients. Abstract 268]

http://www.docguide.com

Return to News Story Page

webmaster@pslgroup.com