Awareness Of Venous Thromboembolism Research Articles

Hematologists’ awareness of venous thromboembolism in multiple myeloma: a national survey in China

Background Venous thromboembolism (VTE) is one of the most common and severe complications of multiple myeloma (MM). The aim of this study was to learn about the current awareness regarding MM-associated VTE among Chinese hematologists. Methods A nationwide, online, questionnaire-based survey was sent to the specialized hematologists in mainland China. The questionnaire investigated respondents’ demographic and occupational characteristics, their ability to identify VTE risk factors, and their thromboprophylaxis decisions for different anti-MM regimens. Six clinical vignettes were used to evaluate hematologists’ awareness of stratified thromboprophylaxis. The data were analyzed using SPSS software. Results A total of 518 valid questionnaires were received. Of the 518 hematologists investigated, only 23.7% of them could identify VTE-related risk factors correctly. Most hematologists could select appropriate thromboprophylaxis for common anti-MM regimens such as VCd (bortezomib, cyclophosphamide, and dexamethasone) and VRd (bortezomib, lenalidomide, and dexamethasone), but not for uncommon ones such as VTD-PACE (bortezomib, thalidomide, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, and etoposide) and KRd (carfilzomib, lenalidomide, and dexamethasone). The results from the vignettes suggested that only 19.5% of the hematologists could be defined as the ‘stratified thromboprophylaxis’ group, and the awareness of stratified thromboprophylaxis depended significantly on physicians’ age and working seniority. Conclusion The results of our study showed that a large proportion of Chinese hematologists failed to recognize the VTE risk factors, most of them cannot select appropriate thromboprophylaxis for different MM therapeutic regimens and lack awareness of stratified thromboprophylaxis for MM-associated VTE. A standard VTE prevention guideline is urgently needed for the Chinese myeloma group. Continuous education for new professionals should be encouraged. A VTE collaborative group is supposed to be established in each hospital to enhance the overall medical care for VTE patients.

Identification of prophylaxis and treatment for hospitalized patients associated with venous thromboembolism.

Identification of prophylaxis and treatment for hospitalized patients associated with venous thromboembolism.

Pregnant and puerperal women's knowledge and awareness of venous thromboembolism: a medical of things survey technique

Pregnant women are at a higher risk of venous thromboembolism (VTE) during pregnancy and postpartum. Coronavirus disease 2019 (COVID-19) infection increases the risk of VTE. This study aimed to assess pregnant and puerperal women’s knowledge and awareness of VTE. The study included 403 females at the maternity hospital in the Al-Ahsa region, Saudi Arabia. All participants were chosen by convenience sampling technique and interviewed about their bio-demographic, clinical, and gynecological data, personal and/or family history of VTE, history of thromboprophylaxis, and knowledge about deep vein thrombosis (DVT) and pulmonary embolism (PE). The results of the study revealed that 284 (70.5%) of the participants had poor knowledge about DVT, and only 119 (29.5%) had a good level of knowledge, with a mean score of 8.7 out of 20. Although VTE prevalence has increased due to COVID-19 and its complications, the study results showed a lack of knowledge and poor awareness of VTE among 70.5% of the study participants. The education of women regarding VTE should be improved, especially among pregnant females. More patient education and public education campaigns are needed to increase public awareness of VTE, especially during the COVID-19 pandemic.

Measurement of the awareness of venous thromboembolism in the Saudi population.

Venous thromboembolism (VTE) causes significant morbidity and mortality. International studies have suggested poor public awareness of VTE, with a few data from Saudi Arabia. The aim of this study was to investigate the knowledge and awareness of VTE in the Saudi population. Awareness of other important diseases was also investigated to allow contextualization. A cross-sectional survey study was conducted throughout Saudi Arabia from April to June 2021. A nonprobability, purposive, social media-driven, snowballing sampling technique was used to distribute a validated online questionnaire to Saudi adults (aged over 18 years) from the general population. Of 1226 respondents, 214 were excluded as they were health-care professionals. The majority of the participants were unaware and unconcerned about VTE. They were more aware of other medical conditions such as hypertension. Immobility and old age were frequently recognized as risk factors for VTE. While less than half of the participants were aware that thrombosis is the cause of VTE, most participants correctly identified leg pain and tenderness as symptoms of deep venous thrombosis. The majority of the participants identified chest pain and breathlessness as symptoms of pulmonary embolism. However, leg paralysis and slow, shallow breathing were frequently identified as symptoms of VTE. The majority of subjects disagreed with the statement, "having a blood clot is not considered a medical emergency." Awareness of VTE varied significantly with age. In Saudi Arabia, the public awareness of VTE is poor. To improve outcomes, public health initiatives must increase awareness, introduce preventive measures, encourage early diagnosis, and ensure compliance with treatment.

Venous Thromboembolism Awareness among Saudis Risk Group at Primary Health Care Centers in Riyadh

Developing specialized health programs for the at-risk public begins with an assessment of knowledge. There is a lack of local research regarding at-risk groups’ knowledge about venous thromboembolism. Our goal is to identify gaps in knowledge about VTE among communities at risk. Methods: Quantitative cross-sectional study design was used. A questionnaire was administered to patients who were followed up in primary health care centers under Riyadh Second Health Cluster , and who were conveniently selected. Descriptive statistics were presented by using the Package for Social Sciences version 24 for statistical analysis. Results: The results showed a total of 823 participants; 30% of them have lack of knowledge about DVT. Also, the majority of participants not aware about causes of a leg clot. More than half of the participants are not aware of PE and they did not report that chest pain, cough with blood, the heart rate becomes rapid as signs of PE. However, few of participants were worried about VTE and they agree that clots may result in death .Finally, the participants agreed that untreated blood clots in the leg cannot travel to the lungs . Conclusion: To achieve the current Saudi Health Council evidence-based clinical practice guidelines, primary health care centers need to activate the role of health care providers. Future research should include a healthy Saudi general population. Educational programs regarding VTE could also be evaluated through interventional studies. The health care providers’ perceptions of VTE and their role in raising awareness about VTE need to be assessed in practice. Key words: Venous thromboembolism, awareness, risk groups, Saudi Arabia

Using the Caprini Risk Score to Increase Awareness of Venous Thrombus Embolism in the Community: Know Your Score II.

To assess individual participants' baseline thrombosis risk calculated by Caprini Risk Score (CRS) before injury, illness, or hospitalization occur, to increase the awareness of venous thromboembolism (VTE) by viewing 2 short videos. A cross-sectional study was conducted online between August 2022 and January 2023 in the USA, UK, and India to assess the risk of thrombosis of individuals as a baseline. One nursing practitioner and 4 high school students were on the research team. Descriptive statistical methods were used in data analysis. A total of 928 usable completed questionnaires from 945 participants were analyzed. The mean CRS was 4.93 ± 3.175; 0 to 4 (N = 460, 49.6%), 5 to 8 (N = 394, 42.5%), and 9 (N = 74: 8.0%). History of blood clots (N = 247, 26.6%), <40 years old (N = 133, 52.6%); women on oral contraceptives (N = 324, 34.9%), history of smoking (30%), diabetes (26%), and inflammatory bowel disease (IBD; 17.3%). Top-level findings: High incidence of family history of thrombosis (26.6%), smoking, diabetes, contraceptives, and IBD. The average CRS (7.9) in patients over 75 years indicates that even a minor surgical procedure may be associated with significant VTE risk. We achieved an important goal by increasing awareness of VTE using this unique method involving high school students and a nurse working with friends and families to complete the CRS assessment. Encouraging the respondents to share information with their personal physicians prior to the event and keep these data in their medical file is a potential valuable source of saving time. This study emphasizes the importance of individuals collecting baseline information prior to illness or hospitalization.

Incidence, Risk Factors, Risk Assessment Model and Compliance of Patients on Anticoagulants for Asymptomatic Venous Thromboembolism in Nononcological Urological Inpatients.

To study the incidence, risk factors for developing asymptomatic venous thromboembolism and the compliance of patients on anticoagulants for asymptomatic venous thromboembolism (VTE) in nononcological urological medium-high risk inpatients, and build a risk assessment model (RAM) for early screening for asymptomatic VTE. We conducted a retrospective analysis of 573 inpatients admitted to a nononcological urological ward of a tertiary hospital in China from January 1, 2017, to June 30, 2019. Data were collected using the electronic medical record system, and patients underwent a follow-up by phone 6 months after discharge. Among the 573 medium-high risk inpatients, 73 (15.4%) were diagnosed with VTE, including 20 (4.2%) symptomatic and 53 (11.2%) asymptomatic. Prior history of VTE, a history of anticoagulants or antiplatelet agents before admission, and D-dimer ≥ 1 were the potential risk factors identified for asymptomatic VTE. Patients with poor awareness of VTE and its dangers, and patients who lived more than 1 hour away from the hospital had a high probability of poor compliance with anticoagulation therapy after discharge. Using D-dimer (1.785 μg/ml), we built a RAM for the early diagnosis of asymptomatic VTE. We found that patients with urinary nontumor VTE had low compliance with anticoagulation therapy after discharge. The key factors for determining asymptomatic VTE in nononcological urological inpatients included prior history of VTE, a history of taking anticoagulants or anti-platelet agents before admission, and D-dimer ≥ 1. Furthermore, we found that the threshold of D-dimer should be elevated to 1.785 μg/ml to predict asymptomatic VTE.

Awareness of venous thromboembolism among patients with cancer: Preliminary findings from a global initiative for World Thrombosis Day

BackgroundCancer‐associated venous thromboembolism (CAT) has detrimental impact on patients' clinical outcomes and quality of life. Data on CAT education, communication, and awareness among the general cancer population are scanty. MethodsWe present the preliminary results of an ongoing patient‐centered survey including 27 items covering major spheres of CAT. The survey, available in 14 languages, was promoted and disseminated online through social networks, email newsletters, websites, and media. ResultsAs of September 20, 2022, 749 participants from 27 countries completed the survey. Overall, 61.8% (n = 460) of responders were not aware of their risk of CAT. Among those who received information on CAT, 26.2% (n = 56) were informed only at the time of CAT diagnosis. Over two thirds (69.1%, n = 501) of participants received no education on signs and symptoms of venous thromboembolism (VTE); among those who were educated about the possible clinical manifestations, 58.9% (n = 119) were given instructions to seek consultation in case of VTE suspicion. Two hundred twenty‐four respondents (30.9%) had a chance to discuss the potential use of primary thromboprophylaxis with health‐care providers. Just over half (58.7%, n = 309) were unaware of the risks of bleeding associated with anticoagulation, despite being involved in anticoagulant‐related discussions or exposed to anticoagulants. Most responders (85%, n = 612) valued receiving CAT education as highly relevant; however, 51.7% (n = 375) expressed concerns about insufficient time spent and clarity of education received. ConclusionsThis ongoing survey involving cancer patients with diverse ethnic, cultural, and geographical backgrounds highlights important patient knowledge gaps. These findings warrant urgent interventions to improve education and awareness, and reduce CAT burden.

S813 Venous Thromboembolism Rates Among Patients Hospitalized for Inflammatory Bowel Disease Exacerbation: A Time Trend Analysis of the National Inpatient Sample

Introduction: Inflammatory bowel disease (IBD) flare increases risk of venous thromboembolism (VTE) events, especially during hospitalization. Guidelines, support the use of VTE prophylaxis for these patients, but it is unclear if this has impacted rates of VTE. Our goal was to assess time trends of VTE rates among IBD admissions. Methods: Patients hospitalized from 2007 to 2019 were identified in the National Inpatient Sample (NIS) by International Classification of Diseases (ICD), 9th and 10th Revision codes. Patients with IBD flare were selected by either a) a primary diagnosis of Crohn’s disease (CD) or Ulcerative colitis (UC) or b) a secondary diagnosis of CD or UC with a primary diagnosis of a gastrointestinal manifestations of IBD: abdominal pain, anemia, malnutrition, or dehydration. Hospitalizations for VTE were identified by those with a primary or secondary diagnosis of VTE. Patients with chronic thrombosis or prior VTE were excluded. Incidence of VTE was assessed by disease type (CD vs. UC) and by racial/ethnic identification: white, black, Hispanic, Asian or Pacific Islander, Native American, other. Cochran-Armitage trend tests were used for binary variables while trends for variables with reported mean averages used linear regression. The Rao-Scott design-adjusted chi-square test was used to evaluate the association between binary variables and the diagnosis of IBD in patients with VTE. Results: 131,541 weighted cases were admitted for an IBD flare complicated by VTE; 73,530 had CD and 58,011 had UC, Table. VTE prevalence was higher among patients with UC compared to CD, 42.6 vs. 30.7 per 1,000 hospitalizations, respectively. Over the study period, the rates of VTE in IBD hospitalizations increased, from 3.58% to 4.62% for UC (p< 0.0001) and from 2.22% to 3.66% for CD (p< 0.0001), Figure 1a. Black patients with IBD were found to be at higher risk of VTE (aOR 1.075, p=0.002), while Hispanic and Asian / Pacific Islanders had lower risk for developing VTE when compared to Whites (aOR 0.873 and 0.658, respectively; p< 0.0001). Aside from Hispanic and Native American UC patients, all races and ethnicities had increasing trends of VTE during the study period, Figure 1b, 1c. Conclusion: IBD admissions complicated by VTE have significantly increased. Though increasing awareness of VTE with IBD flare may have resulted in additional diagnoses, the study findings suggest that current VTE prophylaxis, or utilization of VTE prophylaxis, may be inadequate for those hospitalized for IBD flare.Figure 1.: VTE rates as % of total IBD hospitalizations per year. Table 1. - Patient Demographics and Hospital Characteristics of IBD Patients Admitted with VTE Variable Crohn's Disease (n=73,530) Ulcerative Colitis (n=58,011) Age in years [Mean(SD)] 56 (0.16) 60 (0.19) Sex Male 43.7% 50.3% Female 56.3% 49.7% Race* White 81.1% 79.6% Black 12.3% 10.4% Hispanic 3.8% 6.1% Asian / Pacific Islander 0.5% 1.1% Native American 0.4% 0.4% Other 1.9% 2.5% Insurance Type Medicare 48.5% 48.9% Medicaid 12.5% 8.8% Private Insurance 32.7% 36.4% Self-Pay 3.2% 2.8% Other 3.1% 3.1% Hospital Bed Size Small 13.8% 13.5% Medium 25.1% 24.8% Large 61.1% 61.7% Hospital Location/ Type Rural 7.2% 6.1% Urban Nonteaching 28.0% 28.9% Urban Teaching 64.8% 65.0% Charlson Comorbidity Index CCI = 0 36.4% 35.5% CCI = 1 21.8% 21.3% CCI = 2 15.5% 14.7% CCI ≥ 3 26.3% 28.6% Hospitalization Cost $95,500 $110,473 Length of Stay (in mean days) 10.39 11.25 Death (per 1,000 hospitalizations) 41.8 61.4 *There were some charts where race was documented in NIS as unknown.

Venous thromboembolism risk screening, training and provider awareness in Australian residential aged care facilities.

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in the geriatric post-surgical population, and its prevention is a public health priority. The aim of this study was to assess the use of VTE risk screening and training protocols, and VTE awareness in the Australian residential aged care sector. A cross-sectional survey was conducted that was directed at facility and policy managers of community aged care facilities with ≥10 residents in two Australian states and territories. Forty-nine of 301 (16.3%) providers responded, representing 249/871 (28.6%) aged care facilities and 20,958/66,121 (31.7%) residents. VTE risk screening protocols were used by 1.2% of facilities (3/249), and 79.5% (198/249) were unaware that VTE is an issue in this population. Only 0.8% (2/249) were aware that risk screening and prophylaxis is required to prevent VTE; none were acting upon this. No facility had specific VTE risk assessment or prevention processes in place. Most residential aged care facilities surveyed do not have VTE risk screening protocols and were unaware of the risk that may be associated with this omission. These results have implications for development and implementation of national and international VTE risk screening guidelines in community care.

Application Effect of the Standard Operating Procedure in the Prevention of Venous Thromboembolism.

Objective To investigate the application effect of the standard operating procedure (SOP) in the prevention of venous thromboembolism (VTE). Methods The clinical data of patients admitted to respiratory, cardiovascular, neurological, and geriatric departments in the hospital (November 2020–May 2021) were retrospectively analyzed, and the patients in line with the inclusion criteria were equally randomized into the observation group (OG) and the control group (CG). The CG was treated with the routine nursing, and the OG received the SOP of VTE prevention additionally. After the record of the incidence of VTE and nursing satisfaction of the two groups, scores of VTE awareness were compared. Results One hundred and twenty patients were included in this study, and no obvious difference was found in the general data of patients (P > 0.05). Compared with the CG, the incidence of VTE of the OG was obviously lower (P < 0.05). After nursing, compared with the CG, scores of VTE awareness in the OG were conspicuously higher (P < 0.001), and scores of VTE awareness of the nursing staff were conspicuously higher than those before nursing (P < 0.001). Compared with the CG, nursing satisfaction of the OG was obviously higher (P < 0.001). Conclusion SOP can reduce the incidence of VTE of patients, improve their disease awareness, and enhance their nursing satisfaction, which should be popularized in practice.

Low awareness of venous thromboembolism among the general population: a call for increased public enlightenment programs.

Venous thromboembolism (VTE) is a notable but often ignored cause of disability and death. Improved public awareness of the symptoms and risks associated with VTE reduces the burden of disease. We aimed to determine the awareness of VTE among the general population. We conducted a population-based study using a pre-tested, pre-validated Ipsos-Reid questionnaire between October 2019 to March 2020. The questionnaire was distributed to consenting adults in the capital cities of Enugu and Ebonyi states of South-Eastern Nigeria to determine their awareness and knowledge of the symptoms and risk factors of VTE. A total of 284 adults participated with a mean age of 32.73 ± 10.33 years and majority (70.8%) had a post-secondary education. While majority were aware of other medical conditions like a heart attack (96.1%), stroke (97.2%), diabetes (98.2%), HIV/AIDS (98.6%), cancer (97.2%) and malaria (98.2), just a few of the subjects were aware of thrombosis (41.5%) and DVT (33.8%). Less than half (42.4%) correctly described DVT as a blood clot in the vein and 13.7% of the respondents knew what PE feels like. A minority of them knew the risk factors of VTE included hospital stay (19.0%), surgery (37.2%), cancer (31.6%), pregnancy (31.6%) and old age (29.6%). Age and gender showed no statistically significant association with awareness of VTE, p value, 0.491 and 0.287, respectively. The awareness of VTE in the general population is low. Public awareness programs should be a public health priority to reduce morbidity and mortality associated with VTE.

Incidence, Clinical Profile and Outcome of Patients with Deep Vein Thrombosis and Pulmonary Embolism at a Community Hospital

ObjectiveTo determine incidence of venous thromboembolism (VTE) and to describe risk factors and demographics at a community hospital setting.MethodsProspective study design, recruited 33 patients at Orange Park Medical Center (OPMC). Study was conducted for a period of two months from Feb 2017 to March 2017.All patients aged 18 years and above with an objectively verified diagnosis of DVT, PE or both were included in the study.Baseline demographic data were retrieved from medical records and descriptive analysis was performed with R.Results:During the study period, the incidence rate of VTE diagnoses was 5.9 per 1000 admits [95% confidence interval (CI): 4- 8.2]. Mean age of the patients with VTE event was 51 years, majority were females (51.5%) and Caucasians (69.6%). The average length of stay in the hospital was 3.42 days.Incidence rate for DVT was 1.3 per 1000 admits [95% CI: 1.3- 4.1] and that for PE was 3.7 per 1000 admits [95% CI: 2.3- 5.7]. DVT's were more common among males (57.1%) compared to females (42.8%), whereas PE's were more common in females (66.66%) compared to males (33.33%).Majority of VTE were provoked episodes, accounting for nearly 64% of all causes. Remaining 36% of VTE events were unprovoked due to hypercoagulable states (21%) and a family history of VTE (15%). Among the provoked events, most common causes were malignancy (21%) and recent surgeries (21%) (Figure 1).Among the patients whose risk factor for VTE was recent surgery, majority of them had orthopedic surgeries (57.1%) and received low molecular weight heparins (LMWHs) as prophylaxis for an average duration of two weeks post- surgery.Our results also showed that, 51.5% of patients diagnosed with VTE had at least 1 risk factor for VTE and 48.4% had 2 or more risk factors.ConclusionThis study provides an estimate of incidence of VTE events in adults at a community hospital setting. A sample size of 5590 hospitalized adult patients were analyzed, of which 33 patients were diagnosed with VTE. There have been very few studies reporting the simultaneous effects of multilevel factors such as demographic and preexisting comorbid conditions on the incidence of VTE. When compared to a previous study on VTE in hospitalized patients by Tsai J et al 1, we found a slightly increased incidence rate of 5.9 VTE's per 1000 admits. The difference in the incidence rate could be due to differences in clinical practice of VTE prophylaxis among clinicians, patient's attitudes towards compliance and adherence to therapies. In regards to the risk factors, our study results were consistent with existing evidence that there is a greater risk for VTE among those patients with malignancies and those who have had recent surgeries 2.Patients undergoing major orthopedic surgery are at particularly high risk for VTE. The current pharmacological recommendations for prophylaxis of VTE are LMWHs, fondaparinux and vitamin K antagonists. The results of several studies support extended prophylaxis for 4 weeks in patients undergoing high risk orthopedic surgeries and surgery for cancer. The optimal duration of VTE prophylaxis in other types of surgery needs further evaluation 3.In summary, the results from this study have several important clinical and public health implications. First, physicians need to be informed of various risk factors for VTE, and to identify those who will benefit from VTE prophylaxis. Second, to increase the awareness of VTE among patients and thereby contribute to improved adherence to prescribed therapies.

Incidence of Venous Thromboembolism in Korea from 2009 to 2013

Incidence of venous thromboembolism (VTE) in Asian population is known to be significantly lower than that in Western population. However, Recent studies from Asia have indicated that the incidence rate of VTE is as high as that in Western population under certain circumstances such as surgery, suggesting that VTE has become a disease of major concern in Asian population. Therefore, data regarding the incidence of VTE and annual change in its incidence are of a crucial importance to understand the influence of VTE on social and medical aspects of Asian population at present and in the future.The objective of the present study was to evaluate annual age- and sex- adjusted incidence rate (ASR) of VTE from 2009 to 2013 in South Korea. In addition, annual change in pattern of VTE treatment over the study period was estimated.South Korea has a compulsory public health insurance coverage system and the National Health Insurance (NHI) service basically covers the whole population living in Korea. Health Insurance Review and Assessment Service (HIRA) is a government-operated organization that builds review and quality assessment system for claims for NHI. All claims data that healthcare service providers submit to HIRA to be reimbursed for a service provided to patient are collected by HIRA, making a nationwide population study feasible. Using the HIRA database, VTE cases from 2009 to 2013 were identified. A VTE case was defined if both diagnostic and medication codes were identified simultaneously in a patient. Coexisting medication codes for unfractionated heparin, low-molecular-weight heparin (LMWH), or direct oral anticoagulant (DOAC; rivaroxaban) were mandatory to verify accurate detection of the VTE. To analyze pattern of VTE treatment, all medical codes of anticoagulants approved for VTE treatment in Korea prescribed within 6 months after the time of VTE diagnosis were collected. In addition, codes of procedures including thrombectomy, thromboplasty, thrombolysis, and placement of inferior vena cava filter recorded from -1 to +6 months of the time of VTE diagnosis were searched. The proportion of cancer-associated VTE, who had diagnostic codes of both cancer and VTE was analyzed.Among 63,184 annual index cases of VTE from 2009 January to 2013 December, incidence rate of VTE was increased yearly. It was significantly higher in older population compared to that in younger population and higher in females compared to that in males. In 2009, ASRs of VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE) were from 21.3, 8.1, and 13.2 per 100,000, respectively. They were increased to 29.2, 12.7, and 16.6 per 100,000, respectively, in 2013 (Table).Prescription rates of warfarin and LMWH were significantly decreased with the introduction of DOAC between 2012 and 2013 (Figure). It might be influenced by benefits of lower cost of rivaroxaban reimbursed by NHI service for 6 months of treatment duration. Although ASR itself was increased, proportions of subjects who received mechanical procedures were decreased annually. Cancer associated VTE accounted for 33.1% of all VTE and they had higher relapse rate compared to those who did not have a diagnostic code of cancer (7.08% vs. 6.54%; p < 0.013).Our near a whole nationwide epidemiologic study shows that ASR of VTE in Korea has continuously increased from 2009 to 2013. The result reflects a rapid aging society, improved awareness of VTE, and improved survival of patients with cancer and other morbidities that complicate VTE. The introduction and reimbursement of DOAC resulted in significant change in the pattern of anticoagulant prescription within a short period of time. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Knowledge of and attitude toward venous thromboembolism among professional drivers in Saudi Arabia

Evidence suggests that professional drivers are at risk for venous thromboembolism (VTE), a life-threatening yet preventable disease. Awareness of VTE among this population has not been assessed in the Middle East. The study aimed to assess professional drivers’ awareness of VTE and attitudes toward VTE preventive measures. We used a validated VTE awareness questionnaire to interview 324 drivers in Saudi Arabia during February-March 2020. Knowledge about VTE was the lowest compared to other medical conditions. Less than a third (31.8%) of the drivers were aware of VTE. Only 15.7% of those with prior awareness correctly identified all four deep vein thrombosis symptoms, and only 7.4% correctly identified all five pulmonary embolism symptoms. A significant proportion believed in unrelated practices for VTE prevention. Health promotion campaigns are urgently needed to raise awareness and to promote healthy behaviors.

Awareness, knowledge, and attitude toward venous thromboembolism among Aseer Population, Saudi Arabia.

Objectives:Calls to carry efforts to increase awareness about venous thromboembolism (VTE) as a preventable major healthcare problem with serious consequences has been upraised. This study was planned to get an overview of the awareness, knowledge, and attitude toward VTE among Aseer population, Saudi Arabia and the need for an education plan.Materials and Methods:Questionnaire composed of 35 questions based cross-sectional study was conducted online via Google documents to public in Aseer that included both genders aged more than 18 years who agreed to be involved in the study, to assess knowledge and attitude toward VTE. The collected data were presented as numbers, percentages, and were analyzed using Statistical Package for Social Sciences version 24.Results:The results of the data showed that awareness knowledge and attitude toward VTE were lacking and unsatisfactory.Conclusion:Diligence to spread knowledge and awareness of VTE among public in Aseer is required. Further surveys involving other populations are warranted.

Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients: A Policy Statement From the American Heart Association.

Venous thromboembolism (VTE) is a major preventable disease that affects hospitalized inpatients. Risk stratification and prophylactic measures have good evidence supporting their use, but multiple reasons exist that prevent full adoption, compliance, and efficacy that may underlie the persistence of VTE over the past several decades. This policy statement provides a focused review of VTE, risk scoring systems, prophylaxis, and tracking methods. From this summary, 5 major areas of policy guidance are presented that the American Heart Association believes will lead to better implementation, tracking, and prevention of VTE events. They include performing VTE risk assessment and reporting the level of VTE risk in all hospitalized patients, integrating preventable VTE as a benchmark for hospital comparison and pay-for-performance programs, supporting appropriations to improve public awareness of VTE, tracking VTE nationwide with the use of standardized definitions, and developing a centralized data steward for data tracking on VTE risk assessment, prophylaxis, and rates.

Knowledge and Awareness of Venous Thromboembolism in Intensive Care Units in Zhejiang Province, China: A Cross-Sectional Survey

BackgroundThe 2009 China Intensive Care Units (ICU) prevention guidelines lack venous thromboembolism (VTE) risk assessment. This survey was conducted to assess the risk of VTE, develop and establish a diagnosis, and provide prevention and treatment guidelines for ICU VTE.Material/MethodsA cross-sectional questionnaire survey of ICU doctors ICUs was conducted online in the tertiary and secondary hospitals of Zhejiang province in China. The questionnaire included VTE-related hospital hardware information, VTE awareness, knowledge, and monitoring system.ResultsThe risk assessment rates at the time of admission and changed disease condition were 67.7% and 60.4%, respectively. D-dimer and ultrasound were commonly used for VTE screening. Heparin is preferred for short-term intravenous anticoagulant therapy, and warfarin is preferred for long-term therapy. We found that 23.53% of the ICUs have bedside ultrasound and staff for ultrasound examination, and 59.4% of the hospitals are equipped with VTE monitoring information systems. The VTE early identification specification is the key to whether the VTE assessment is performed after the patient enters the ICU.ConclusionsThe survey assessed the VTE risk and key VTE management elements. However, high heterogeneities were detected in the assessment. The ICU doctors have relatively limited awareness of VTE. Thus, there is an urgent need to update and standardize the ICU VTE guidelines for the prevention and treatment of VTE in China.

Awareness and Perception of Thromboembolism and Thromboprophylaxis among Hospitalized Patients in Jordan.

Background and Objective: Despite the established importance of thromboprophylaxis in patients with Venous Thromboembolism (VTE), a limited number of studies have assessed the awareness of VTE and thromboprophylaxis therapy among the affected patients. The aim of the current study was to assess awareness and to explore variables associated with awareness about VTE and its thromboprophylaxis.Methods: A cross-sectional study was conducted on hospitalized patients who received thromboprophylaxis (5000 units of heparin subcutaneously (SC) q8-12h, or 30-40 mg of enoxaparin SC once daily). In addition to the sociodemographic variables, awareness and perception of VTE and its thromboprophylaxis were assessed using a validated questionnaire. Multiple logistic regressions were conducted to build a model of variables significantly associated with VTE awareness.Results: A total of 225 patients participated in the study, with only 38.2% and 22.2% of the participants being aware of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) respectively. Logistic regression showed that the participants with low educational level had 3.046 value, with the odds being not aware of DVT or PE compared with participants with high educational level. Participants without a personal history of VTE had 7.374 value, with the odds being not aware of DVT or PE compared with those who had a personal history of VTE. Participants who had a negative perception of VTE had 2.582 value, with the odds being not aware of DVT or PE compared with participants who had a positive perception and those who did not have any information about DVT or PE had 13.727 value, with the odds being not aware of DVT or PE.Conclusion: The findings reveal that there is a lack of awareness about VTE and its thromboprophylaxis among the study participants. Patients with lower educational level and those with no history of previous VTE need awareness improvement about VTE and its thromboprophylaxis. Clinical Pharmacists need to focus on providing information about VTE and improving patients’ perception about VTE and its thromboprophylaxis with the aim of improving the awareness about VTE, and hence the better health outcome.

Abstract P382: Impact Of Autoimmune Disease On Acute Venous Thromboembolism Incidence After Pregnancy

Introduction: Venous thromboembolism (VTE) is a leading cause of mortality in the postpartum period. Several autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus and Crohn’s disease, have been found to increase risk of VTE by upregulating the body’s procoagulants while decreasing physiologic anticoagulants via systemic inflammation. No existing studies have estimated the association of these risk factors exclusively among postpartum women. Hypothesis: Presence of autoimmune disease will be associated with increased risk of VTE among postpartum women. Methods: We identified a cohort of 755,722 women ages 15-45 with an international classification of disease code (ICD) for delivery in the 2011-2017 U.S. MarketScan Commercial administrative database. The exposure of prevalent autoimmune disease, represented by 29 endocrine, antibody positive, digestive and vascular diseases, was identified by two or more inpatient or outpatient ICD codes occurring before a woman’s delivery date. VTE events between the delivery hospital discharge and 12 weeks postpartum were defined using validated algorithms of ICD codes and confirmatory evidence of anticoagulant prescriptions. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) adjusted for age, hypertension, gestational diabetes, preeclampsia, multiple gestation and antepartum hemorrhage. Associations were also evaluated separately by specific autoimmune disease category (endocrine, antibody positive, digestive, vascular). Results: The average age of women was 30.7 years (SD: 5.4 years) and 27,322 out of the 755,722 deliveries (3.6%) occurred among women with prevalent autoimmune disease. Of these, 10,555 were endocrine diseases (1.4%), 12,851 were antibody positive diseases (1.7%), 4,634 were digestive diseases (0.6%) and 353 were vascular diseases (0.1%). There were 3,502 postpartum VTE events; among them 235 (6.7%) occurred in women with prevalent autoimmune disease. In the adjusted model, women with autoimmune disease had higher postpartum rate of VTE (HR: 1.54; 95%CI: 1.25, 1.90) relative to those without. When evaluating the subgroups separately, the rate of VTE was elevated among women with digestive (HR: 1.73; 95%CI: 1.09, 2.76) and antibody positive (HR: 1.82; 95%CI: 1.38, 2.39) autoimmune diseases. Conclusions: Women with autoimmune disease were at 50% greater risk of postpartum VTE as compared to women without these conditions. The association was more pronounced for women with digestive and antibody positive autoimmune disease. Given the importance of maternal mortality as an outcome, these findings suggest value for increasing VTE awareness among women with these autoimmune conditions and their healthcare providers.