Abstract TP284: The Risk of Venous Thromboembolism Among Patients Hospitalized for Acute Ischemic Stroke in the US

Abstract

Introduction: There is a high risk for venous thromboembolism (VTE) among patients hospitalized for acute ischemic stroke. Prophylactic anticoagulant therapy may reduce such risk. The aim of this study was to evaluate the receipt of VTE prophylaxis and VTE risk among patients hospitalized in the US for acute ischemic stroke. Methods: Patients hospitalized with acute ischemic stroke from 1/1/2012 to 6/30/2015 were identified from the MarketScan Commercial and Medicare databases. The first of such hospitalization to occur was defined as the index hospitalization. Patients were required to have continuous insurance coverage for the 6 months before (baseline period) and after (follow-up period) the index hospitalization. The proportion of patients who received VTE prophylaxis was determined. Additionally, Kaplan-Meier analysis was used to evaluate VTE risk following the index hospitalization. Results: Among patients hospitalized for acute ischemic stroke (n=1,148; mean age 69 years), 54.1% were female. During the index hospitalization, 48.4% (n=556) of patients received inpatient VTE prophylaxis. During the follow-up period, 15.9% (n=183) of patients received outpatient prophylaxis. Among these patients, 48.3% (n=554) did not receive any VTE prophylaxis and 12.6% (n=145) received both inpatient and outpatient VTE prophylaxis. Among this patient population, 1.1% (n=12) had a VTE event during the index hospitalization and 2.0% (n=23) had a VTE event after hospital discharge. The risk for VTE among such patients remained high for up to approximately 30-40 days after the index hospitalization (Figure). Conclusions: Despite a high risk for VTE, nearly half of patients hospitalized for acute ischemic stroke received no VTE prophylaxis therapy. Increased prophylaxis therapy may improve patient outcomes in this population.