Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 1998 Jun;13(6):373-8.
doi: 10.1046/j.1525-1497.1998.00117.x.

Anticoagulation therapy in patients with venous thromboembolic disease

J Whittle  1 , P Johnson, A R Localio
Affiliations

Anticoagulation therapy in patients with venous thromboembolic disease

J Whittle et al. J Gen Intern Med. 1998 Jun.

Abstract

Objective: To determine, in a representative sample of patients drawn from a variety of hospitals, the degree of adherence to consensus recommendations for anticoagulation among patients with deep vein thrombosis or pulmonary embolism.

Design: Cross-sectional review of a population-based random sample.

Setting: Twenty-one randomly selected Pennsylvania hospitals.

Patients: Of 357 randomly selected Medicare beneficiaries discharged from study hospitals with a diagnosis of deep venous thrombosis or pulmonary embolism during 1992, 43 charts were not reviewed for administrative reasons, 31 were miscoded or not treated with intravenous administration of heparin, and 13 were excluded for other reasons, leaving 270 in the final sample.

Measurements and main results: Overall, 179 patients (66%, 95% confidence interval [CI] 59%, 72%) received therapeutic anticoagulation (two consecutive partial thromboplastin times more than 1.5 times control) within 24 hours of starting heparin. Platelet counts were checked at least once during the first week of heparin therapy in 66% (95% CI 58%, 74%). At least 5 days of heparin therapy was given to 84% (95% CI 79%, 87%). Among 266 (99%) of the patients receiving warfarin, 193 (72%; 95% CI 63%, 80%) received heparin until the prothrombin time ratio or International Normalized Ratio was therapeutic. Patients who were started on warfarin therapy within 2 days of heparin had decreased length of stay (geometric mean 8.2 vs 9.7 days, p = .003). Compliance varied among hospitals.

Conclusions: In a wide variety of hospitals, we found fair, but variable, compliance with consensus recommendations for anticoagulation of patients with venous thromboembolic disease. Simple interventions to improve compliance with these recommendations might improve quality of care and reduce costs.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Time (in hours) from start of heparin to therapeutic partial thromboplastin time among patients treated for venous thromboembolic disease.
Figure 2
Figure 2
Duration of intravenous heparin therapy among patients treated for venous thromboembolic disease.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Anderson FA, Wheeler HB. Physician practices in the management of venous thromboembolism: a community-wide survey. J Vasc Surg. 1992;16:707–14. - PubMed
    1. Goldhaber SZ, Morpurgo M. Diagnosis, treatment and prevention of pulmonary embolism. JAMA. 1992;268:1727–33. - PubMed
    1. Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease. Chest. 1995;108(suppl):S335–51. - PubMed
    1. Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease. Chest. 1986;89(suppl):S26–35. - PubMed
    1. Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease. Chest. 1989;95(suppl):S37–51. - PubMed