Pharmacologic prophylaxis for venous thromboembolism and 30-day outcomes among older patients hospitalized with heart failure: an analysis from the adhere national registry linked to medicare claims Full Text
Clinical Cardiology, 11/23/2011
Kociol RD et al. – Pharmacologic venous thromboembolism (VTE) prophylaxis is provided to one–third of older patients hospitalized with heart failure. Treatment with LMWH or unfractionated heparin (UFH) did not have a statistically significant association with 30–day postdischarge outcomes.Methods
- Using data from the Acute Decompensated Heart Failure (ADHERE) registry linked to Medicare claims, authors estimated 30–day postdischarge outcome rates for patients who received in–hospital subcutaneous heparin compared with patients who did not receive in–hospital VTE prophylaxis.
- Authors excluded patients who received warfarin or intravenous heparin.
- Outcomes included mortality, thromboembolic events, major adverse cardiovascular events, and all–cause readmission.
- Authors used propensity–score methods to estimate associations between VTE prophylaxis and each outcome.
- In a secondary analysis, authors compared outcomes of patients receiving pharmacologic prophylaxis with unfractionated heparin (UFH) vs low–molecular–weight heparin (LMWH).
- Of 36 799 eligible patients in 265 hospitals, 12 169 (33%) received pharmacologic VTE prophylaxis during the hospitalization.
- In unadjusted analysis and after weighting by the inverse probability of treatment, VTE prophylaxis was not associated with 30–day postdischarge mortality, thromboembolic events, major adverse cardiovascular events, or all–cause readmission.
- There were no differences in outcomes between patients receiving UFH and those receiving LMWH.