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. 2023;28(5):452-456.
doi: 10.5863/1551-6776-28.5.452. Epub 2023 Oct 3.

Optimization of Thromboprophylaxis Use in Hospitalized Pediatric Patients Through Implementation of a Venous Thromboembolism Risk Assessment Tool

Airka Sanchez  1 , Lauren Campanella  1 , Kimberly Perez  1
Affiliations

Optimization of Thromboprophylaxis Use in Hospitalized Pediatric Patients Through Implementation of a Venous Thromboembolism Risk Assessment Tool

Airka Sanchez et al. J Pediatr Pharmacol Ther. 2023.

Abstract

Objective: Venous thromboembolism (VTE) is a leading cause of hospital-acquired morbidity for pediatric patients. Pharmacological thromboprophylaxis increases the risk of adverse events such as bleeding complications. There exists a need for a universal VTE risk assessment tool to aid in thromboprophylaxis prescribing while minimizing the risk of adverse events. The objective of this study is to investigate if implementation of a VTE risk assessment tool is associated with a change in the rate of thromboprophylaxis prescribing.

Methods: This retrospective study evaluated the change in thromboprophylaxis prescribing pre and post implementation of a VTE risk assessment tool. Patients were excluded if they were pregnant, diagnosed with VTE ≤48 hours of admission, presented with VTE symptoms, or if they were diagnosed with multisystem inflammatory syndrome in children (MIS-C) or coronavirus disease (COVID-19).

Results: A total of 186 pediatric patients were included in this study. Thromboprophylaxis was prescribed in 16/93 (17.12%) and 75/93 (80.6%) patients in the pre- and post-implementation group, respectively (95% CI, 0.523-0.745; p < 0.001). No VTE events occurred in either group. Bleeding complications occurred in 3.2% and 7.5% of patients in the pre- and post-implementation groups, respectively. The risk tool was used in 80.6% of patients; providers used the tool correctly in 48% of patients and incorrectly in 52% of patients.

Conclusion: Implementation of a VTE risk assessment tool was associated with a statistically significant change in the rate of thromboprophylaxis prescribing. Incorrect use may be minimized by providing provider reeducation and making modifications to the order set.

Keywords: anticoagulants; pediatrics; pharmacy; retrospective studies; risk assessment; risk factors; venous thromboembolism.

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Facility VTE Risk Assessment Tool.
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References

    1. Faustino EV, Raffini LJ. Prevention of hospital-acquired venous thromboembolism in children: a review of published guidelines. Front Pediatr . 2017;5:9. - PMC - PubMed
    1. Monagle P, Cuello CA, Augustine C et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv . 2018;2((22)):3292–3316. - PMC - PubMed
    1. Mahajerin A, Croteau SE. Epidemiology and risk assessment of pediatric venous thromboembolism. Front Pediatr . 2017;5:68. - PMC - PubMed
    1. Jaffray J, Branchford B, Goldenberg N et al. Development of a risk model for pediatric hospital-acquired thrombosis: a report from the Children’s Hospital-Acquired Thrombosis Consortium. J Pediatr . 2021;228:252–259.e1. - PMC - PubMed
    1. Park MY, Fletcher JP, Hoffmann C et al. Prevention of venous thromboembolism through the implementation of a risk assessment tool: a comparative study in medical and surgical patients. Int Angiol . 2018;37((5)):411–418. - PubMed

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