Is Prophylactic Anticoagulation for Deep Venous Thrombosis Common Practice After XXXX ?

@entity1 @entity1150 @entity1410 @entity1779 @entity130
BACKGROUND AND PURPOSE: Prophylactic anticoagulation for @entity1150 prevention after @entity1779 ( @entity1779 ) is safe. Current guidelines recommend prophylactic anticoagulation after cessation of @entity1410 growth. We aimed to evaluate nationwide trends in @entity1150 prophylaxis after @entity1779 . METHODS: In an analysis of the Premier database, we identified adult @entity1 with @entity1779 (International Classification of Diseases Ninth edition code 431) from 2006 to 2010 who survived to day 2 of hospitalization. We excluded those with @entity130 or who underwent craniotomy or angiography. We abstracted type of anticoagulant used and date of first administration. We used univariate statistics and multivariable logistic regression to assess factors associated with prophylactic anticoagulation after @entity1779 . RESULTS: Among 32 690 (mean age, 69.7 years; 50.1% @entity1 ) @entity1 with spontaneous @entity1779 , 5395 (16.5%) @entity1 received any prophylactic anticoagulation during the hospital stay. Among these @entity1 , 2416 (44.8%) received prophylactic anticoagulation by day 2. The most commonly used agents were heparin (71.1%), enoxaparin (27.5%), and dalteparin (1.4%). The proportion of @entity1 receiving prophylactic anticoagulation increased slightly during the study period from 14.3% to 18.0% (P<0.01 for trend). Use of prophylactic anticoagulation varied by geographic region (P<0.001) in the United States: Northeast (23.2%), South (19.0%), Midwest (10.8%), and West (9.8%). In multivariable analysis, geographic region remained an independent predictor of prophylactic anticoagulation. CONCLUSIONS: Less than 20% of @entity1 with @entity1779 receive anticoagulation for @entity1150 in the United States. When used, the time to initiation is <2 days in less than half of the @entity1 . Further study should focus on understanding variations in practice and emphasize guideline-driven care.
