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    Risk-assessment models for predicting venous thromboembolism among hospitalized non-surgical patients: a systematic review

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    Authors
    Huang, Wei
    Anderson, Frederick A. Jr.
    Spencer, Frederick A.
    Gallus, Alexander S.
    Goldberg, Robert J.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Department of Surgery, Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2012-07-24
    Keywords
    Venous Thromboembolism
    Risk Assessment
    Cardiovascular Diseases
    Health Services Research
    
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    Link to Full Text
    http://dx.doi.org/10.1007/s11239-012-0780-0
    Abstract
    Venous thromboembolism (VTE) prophylaxis is suboptimal in American hospitals despite long-standing evidence-based recommendations. Data from observational studies indicate a lower uptake of effective prophylaxis in patients hospitalized with medical versus surgical conditions. Reluctance to use prophylaxis in medical patients has been attributed to difficulty in identifying at-risk patients and balancing risks of bleeding against occurrence of VTE. Several risk-assessment models (RAMs) have been proposed to assist physicians in identifying non-surgical patients who need prophylaxis. We conducted a systematic review of published RAMs, based on objective criteria, to determine whether any RAM is validated sufficiently to be employed in clinical practice. We identified 11 RAMs, six derived from primary data and five based on expert opinion. The number, types, and strength of association of VTE risk predictors were highly variable. The variability in methods and outcome measurement precluded pooled estimates of these different models. Published RAMs for VTE lack generalizability and adequate validation. As electronic health records become more ubiquitous, validated dynamic RAMs are needed to assess VTE risk at the point-of-care in real time.
    Source

    Huang W, Anderson FA, Spencer FA, Gallus A, Goldberg RJ. Risk-assessment models for predicting venous thromboembolism among hospitalized non-surgical patients: a systematic review. J Thromb Thrombolysis. 2012 Jul 24. [Epub ahead of print]. DOI: 10.1007/s11239-012-0780-0

    DOI
    10.1007/s11239-012-0780-0
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27302
    PubMed ID
    22826096
    Related Resources
    Link to article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11239-012-0780-0
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