Prevention Of Complications In Patients Research Articles

Trends in Stroke Prevention between 2014 and 2018 in Hospitalized Atrial Fibrillation Patients.

In recent years, significant changes in stroke prophylaxis in patients with atrial fibrillation (AF) have been observed. Non-vitamin K antagonist oral anticoagulants (NOACs) are more commonly used in the prevention of thromboembolic complications in patients with AF. The aim of the study was to evaluate recommended stroke prophylaxis in patients with AF and to identify predictors of using NOACs in patients treated with anticoagulant therapy. The present study was a retrospective, observational, single-center study which included consecutively hospitalized patients in the reference cardiology center from January 2014 to December 2018. In the study group of 4027 patients with AF, to prevent thromboembolic complications, OACs were used in 3680 patients (91.4%), an antiplatelet drug(s) was used in 124 patients (3.1%), and 223 patients (5.5%) did not undergo any thromboembolic event prevention. In the group of 3680 patients treated with OACs, 2311 patients (62.8%) received NOACs and 1639 patients (37.2%), VKAs. Independent predictors of the use of NOACs were age (OR, 1.02; 95% CI, 1.01–1.03; P < 0.001), a previous thromboembolic event (OR, 1.29; 95% CI, 1.01–1.65; P=0.04), nonpermanent AF (OR, 1.61; 95% CI, 1.34–1.93; P < 0.001), and eGFR (OR, 1.22; 95% CI, 1.02–1.46; P=0.03). Between 2014 and 2018, an increase of patients treated with OACs, mainly with NOACs, was observed. Age, past thromboembolic complications, nonpermanent AF, and preserved renal function determined the choice of NOACs.

PHARMACODYNAMICS OF ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION IN THE ACUTE PERIOD OF ISCHEMIC STROKE

Background. Every fifth ischemic stroke is caused by a patient’s history of atrial fibrillation. Nowadays, direct and indirect oral anticoagulants are widely used to prevent thromboembolic complications in patients with atrial fibrillation. However, despite the prescription of this group of drugs, every year 1–2% of patients with atrial fibrillation have an ischemic stroke. In this situation, a number of questions take rise: if it is possible to carry out thrombolytic therapy in the patients who have been taking anticoagulants; if it is worth resuming anticoagulant therapy after a stroke; when exactly this should be done; and what drugs should be used to prevent another stroke.The aim of this review was to summarize the available clinical guidelines and research results on the study of the anticoagu- lant therapy characteristics in patients with atrial fibrillation after an ischemic stroke.Materials and methods. For this review, the information presented in the scientific literature from open and available sourc- es, has been used. The information had been placed in the following electronic databases: PubMed, Scopus, Web of Sci- ence Core Collection, Cochrane Library, ClinicalTrials.gov; Elibrary, Cyberleninka, Google Academy. The covering period was 1997–2020. The search queries were: “ischemic stroke + atrial fibrillation + anticoagulants”; “ischemic stroke + atrial fibrillation + direct oral coagulants” and “atrial fibrillation + ischemic stroke + warfarin” in both Russian and English equivalents.Results and conclusion. Currently, the problem of the use of anticoagulants for the prevention of recurrent thromboembolic complications in patients with AF in the acute period of a stroke, is studied insufficiently. The difficulties are caused by the delivery of TLT in the patients who have been taking DOACs, first of all, due to the impossibility of an accurate assessment of the hemostasis state because of the unavailability of routine specific tests; and second, as a result of the lack of registered antidotes for most drugs, and their high costs. Besides, there are no RCTs dedicated to the study of the optimal time for the resumption or initiation of anticoagulant therapy in the acute period of an IS, and the optimal drugs for this group of patients. Most of the existing recommendations on these aspects, are based on the consensus of experts, and this fact indicates the need for further research in the area under review.

The role of neurodegeneration biomarkers in the management of patients with diabetic retinopathy

This literature review focuses on the role of disease biomarkers in the management of patients with diabetic retinopathy (DR) investigating in detail the problem of retinal neurodegeneration in such patients. Identification and assessment of the significance of qualitative and quantitative biomarkers of DR and neurodegeneration can complement screening examination, as well as help predict the course of the disease and the response to therapy. A comprehensive analysis of these factors allows for effective treatment and prevention of complications in patients with DR based on prognostic models and dynamic monitoring of these indicators.

Integral tests of the hemostasis system in assessing the efficiency of acetylsalicylic acid in patients with ischemic heart disease

Despite the fact that acetylsalicylic acid (ASA) is the "gold" standard for the prevention of cardiovascular complications in patients with coronary heart disease (CAD), a number of patients still have risks of atherothrombosis. In the present study, the antithrombotic effect of ASA in patients with CAD was assessed in platelet-rich plasma (PRP) using integral tests of the hemostasis study: the T-TAS system (Total Thrombus-formation Analysis System) and the thrombin generation test (TGT). The study involved 34 patients with stable CAD (11 women, 23 men) and people (15 women, 18 men) in the control group. As a result of assessing the activity of thrombus formation using the T-TAS system, a significant decrease in the area under the curve (AUC10) was found in the group with CAD patients compared with the control (135.6 [88.0-222.3] and 260.5 [217.3-301.9], respectively, p.

Methods of prevention of thromboembolic complications in patients with atrial fibrillation

Methods of prevention of thromboembolic complications in patients with atrial fibrillation

Biotechnical System and fuzzy logic Models for Prediction and Prevention of Post-Traumatic Inflammatory Complications in Patients with Closed Renal Trauma

Biotechnical System and fuzzy logic Models for Prediction and Prevention of Post-Traumatic Inflammatory Complications in Patients with Closed Renal Trauma

PREVENTION OF COMPLICATIONS IN PATIENTS WITH MYOCARDIAL INFARCTION AND CONCOMITANT METABOLIC SYNDROME

In Ukraine, coronary heart disease is still occupying the first place in the structure of the causes of death and primary disability (22.8%), and the incidence of myocardial infarction among people of working age is 48.9 per 100 thousand. The aim of this study was to increase the effectiveness of the treatment and prevention of complications in patients with acute coronary syndrome (myocardial infarction) and concomitant metabolic syndrome by including L-carnitine and L-arginine to the integrated therapy. The study involved 71 patients with acute coronary syndrome (ACS) with ST-segment elevation and concomitant metabolic syndrome. Among the 37 individuals who were prescribed a course of cytoprotective therapy additional to the standard drug therapy according to the protocol of the Ministry of Health, formed a test group. The control group consisted of 34 patients who only received standard protocol treatment with corticosteroids (MI). The diagnosis of acute myocardial infarction was verified according to the ESC recommendations (2017). Diagnosis of metabolic syndrome (MS) was established based on the recommendations of the International Diabetes Federation (IDF, 2016). It was found that due to the integrated therapy including L-arginine and L-carnitine, the patients with ACS (MI) and concomitant MS achieved a significant improvement in central cardiohemodynamics and the restoration of vascular endothelial function that was often accompanied by the following complications of corticosteroids (MI) as reperfusion arrhythmias and blockades and acute heart (left ventricular) failure. The patients with acute myocardial infarction and concomitant MS demonstrated pronounced deterioration of morpho-functional parameters of the heart, and namely the development of its post infarction remodelling with subsequent impairments of systolic and diastolic heart function and the development of heart failure and endothelial vascular dysfunction. A mixture of L-arginine and L-carnitine added to the standard therapy significantly reduces the incidence and severity of complications of acute MI such as reperfusion arrhythmias and acute left ventricular failure.

Interrelation between markers of system of hemostasis and hemocoagulation disorders in patients with tuberculosis of respiratory organs and comorbid diabetes mellitus after surgical intervention on respiratory organs

The relevance of the work is determined by the necessity to study markers of coagulation system of blood and hemocoagulation disorders in patients with pulmonary tuberculosis and comorbid diabetes mellitus in different stages of postoperative period.&#x0D; Aim. To determine the interrelation between markers of system of hemostasis and signs of development of intravascular blood coagulation in patients with pulmonary tuberculosis and comorbid diabetes mellitus (TB-DM) depending on the volume of surgical intervention on the respiratory organs.&#x0D; Materials and Methods. The extent of changes of markers of the system of hemostasis was determined in 89 patients with TB-DM before and after surgical treatment. Parameters of coagulation system of blood: concentration of fibrinogen, the level of soluble fibrin-monomer complexes, compensatory potentials by the level of fibrinolysis, activity of fibrinolytic system and of anticoagulation system (antithrombin III) were determined; parameters of prothrombin activity were studied. Besides, operation material of lungs was prepared for morphological examination.&#x0D; Results. A general tendency to increase in the parameters of hypercoagulation syndrome was identified in all the study groups starting from the 3rd-5th day and reaching maximum on the 7th-10th and 14th-17th days of the postoperative period, with compensatory activation of fibrin-stabilizing factor and of fibrinolytic system. Changes in the markers of hemostasis were most prominent in the group of patients after lobectomy. Microthrombotic lesions of the vessels of pulmonary microcirculation with partial or complete obturation of the lumen were morphologically visualized.&#x0D; Conclusion. On the basis of the data obtained a conclusion can be made about the existence of pronounced hypercoagulation syndrome with phenomena of intravascular coagulation of blood in this category of patients, which evidently requires timely prevention and treatment of thromboembolic complications. The results obtained may be used for development of measures aimed at prevention of hemocoagulation complications in patients with TB-DM after the conducted surgical treatment.

Modern Approaches to Optimal Antithrombotic Therapy for Stable Ischemic Heart Disease

The article highlights the practical aspects of the use of antithrombotic therapy in patients with stable (chronic) coronary artery disease (САD). The САD verification using modern functional and anatomical diagnostic methods are considered. Patients with stable САD represent a heterogeneous group, having various clinical scenarios. Information is provided on the main risk factors for ischemic and hemorrhagic complications that determine the choice of optimal antithrombotic therapy regimens. Modern views on the monotherapy and clopidogrel in САD are presented. The data of the largest international studies CHARISMA and PEGASUS-TIMI 54 on the use of double antiplatelet therapy in patients with stable IHD reflected in modern guidelines are highlighted. Features of new antiplatelet agents (prasugrel and ticagrelol) are described. Based on the results of the COMPASS study, indications for the administration of small doses of rivaroxaban in combination with aspirin for the secondary prevention of cardiovascular complications in patients with stable manifestations of atherosclerosis with a low risk of bleeding are considered. The use of antithrombotic therapy is associated with an increased risk of bleeding and particularly with gastrointestinal bleeding. The information on the use of drugs for the prevention of gastrointestinal bleeding is provided.Antithrombotic therapy can reduce the risk of complications associated with atherothrombosis, however, to improve prognosis a multipurpose intervention is required, including correction of risk factors and the use of drugs from different groups with proven effectiveness. Optimal medical therapy, including antithrombotic drugs, is vital for patients with САD and can successfully prevent adverse outcomes.

Expanding the role of nurses in prevention of complications in patients with atrial fibrillation

The important problem in the prevention of complications of diseases connected to cardiac rhythm impairment is a low level of knowledge of our patients and lack of self-analysis and self-control skills. In the article, the authors share their experience in solving the priority problems of atrial fibrillation patients.

Atrial Fibrillation and Diabetes Mellitus: the Control of Thromboembolic Risk

Atrial fibrillation is one of the most common concomitant diseases in patients with diabetes mellitus (DM). Meta-analyses of multiple studies have shown that the risk of AF is higher for diabetic patients with impaired glucose homeostasis than for patients without DM. Patients with AF and DM were younger, more frequently had arterial hypertension, chronic kidney disease, heart failure, and ischemic heart disease, and stroke and were characterized with a more severe course of AF. The article discusses possible mechanisms of the mutually aggravating effects of DM and AF, scales for evaluating the risk of bleeding (CHADS2, CHA2DS2‑VASc, HAS-BLED), and the role of anticoagulants. A meta-analysis of 16 randomized clinical studies, including 9 874 patients, has demonstrated the efficacy of oral anticoagulants in prevention of stroke with an overall decrease in the relative risk by 62 % compared to placebo (95% confidence interval, from 48 to 72 ). For prevention of complications in patients with AF and DM, current antithrombotic therapies can be used, specifically the oral factor Xa inhibitor, rivaroxaban, which is the best studied in patients with AF and DM and represents a possible alternative to warfarin in such patients.

Self-Care in Adults with Type 2 Diabetes Mellitus: A Systematic Review.

Self-care is essential for the prevention of complications in patients with diabetes, but several authors report that even with health education programs, the incidence of complications in patients with diabetes continues to increase. We aimed to examine adherence to self-care strategies and the repercussions of adherence on the clinical profiles of individuals with type 2 diabetes. We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched for related studies in 4 databases: PubMed, Web of Science, Scopus, and Latin American and Caribbean Health Science Literature (LILACS). We included observational studies in English and Portuguese that evaluated the effects of selfcare in individuals with type 2 diabetes. The search resulted in the identification of 615 articles, of which 34 met all the inclusion criteria. General self-care was considered unsatisfactory. Physical exercise was classified as the self-care activity that was performed less frequently by individuals with type 2 diabetes mellitus; adherence to medication was the most frequent behavior among volunteers. The studies indicated poor adherence of the population to good self-care practices, reflected by the increase in complications related to DM.

Hodnocení operačního rizika u pacientů s jaterní cirhózou

The prevalence of liver cirrhosis in population is increasing, as well as its prevalence among patients admitted to hospital for elective surgery. These patients are at risk of high postoperative morbidity and mortality. Perioperative risk assessment of patients with liver cirrhosis is a complex procedure. It consists of evaluation of general condition of the patient, including comorbidities and nutritional status, evaluation of the grade of liver disease, and urgency of the surgical procedure. There are no specific guidelines. Proper risk assessment before surgery, considering alternative ways of treatment, is a cornerstone of optimal postoperative course and prevention of complications in patients with liver cirrhosis.

Dexmedetomidine for prevention of postoperative pulmonary complications in patients after oral and maxillofacial surgery with fibular free flap reconstruction:a prospective, double-blind, randomized, placebo-controlled trial

BackgroundPostoperative pulmonary complications (PPCs) are common and significant problems for oral and maxillofacial surgery patients. Dexmedetomidine (DEX), an α2-adrenoreceptor agonist, has been proven having lung protection effects. However, since now, there has not been final conclusion about whether DEX can reduce the incidence of PPCs. We hypothesize that, in oral and maxillofacial surgery with fibular free flap reconstruction patients, DEX may decrease the incidence of PPCs.MethodsThis was a prospective, double-blind, randomized, placebo-controlled, single-centered trial with two parallel arms. A total of 160 patients at intermediate-to-high risk of PPCs undergoing oral and maxillofacial surgery with fibular free flap reconstruction and tracheotomy were enrolled and randomized to receive continuous infusion of either DEX or placebo (normal saline). 0.4 μg/kg of DEX was given over 10mins as an initial dose followed by a maintaining dose of 0.4 μg/kg/h till the second day morning after surgery. At the same time, the normal saline was administered a similar quantity. The primary outcome was the incidence of PPCs according to Clavien-Dindo score within 7 days after surgery.ResultsThe two groups had similar characteristics at baseline. 18(22.5%) of 80 patients administered DEX, and 32(40.0%) of 80 patient administered placebo experienced PPCs within the first 7 days after surgery (relative risk [RR] 0.563,95% confidence interval [CI] 0.346–0.916; P = 0.017). In the first 7 days after surgery, the DEX group had a lower incidence of PPCs and a better postoperative survival probability (Log-rank test, P = 0.019), and was less prone to occur PPCs (Cox regression, P = 0.025, HR = 0.516). When the total dose of DEX was more than 328 μg, the patients were unlikely to have PPCs (ROC curve, AUC = 0.614, P = 0.009).ConclusionsFor patients undergoing oral and maxillofacial surgery with fibular free flap reconstruction and tracheotomy who were at intermediate or high risk of developing PPCs, continuous infusion of DEX could decrease the occurrence of PPCs during the first 7 days after surgery and shorten the length of hospital stay after surgery, but did not increase the prevalence of bradycardia or hypotension.Trial registrationChinese Clinical Trial Registry, www.chictr.org.cn, number: ChiCTR1800016153; Registered on May 15, 2018.

Relationship of type 2 diabetes mellitus and cardiovascular pathology: significance of glycemic control on the way to solving the problem

Cardiovascular diseases (CVD) is the most frequent cause of death in diabetes mellitus (DM) patients, and diabetes, in turn, significantly increases the risk of cardiovascular pathology, and therefore the implementation of measures for primary and secondary prevention of complications in patients with DM and CVD is a topical direction of modern medicine. In case of diabetes, CVDs occur 2-5 times more frequently than in persons without this pathology. There is also a high risk of developing conditions such as coronary heart disease (CHD), myocardial infarction (MI), arterial hypertension (AH), acute cerebrovascular disease (ACVD). Thus, 69% of patients with DM have dyslipidemia, 80% - AH, 50-75% - diastolic dysfunction, 12-22% - chronic heart failure (CHF). Mortality from MI among patients with DM is 1.5-2 times higher than among people who do not suffer from this disease, both in the acute stage of MI, and in prolonged observation. Therefore, it is necessary to work out a common approach to this problem on behalf of both cardiologists and endocrinologists, and patients, which will improve the quality of treatment and prevent the development of DM complications. Intensive control of glycemia in patients is essential to prevent the development and progression of DM complications, which is proved by a number of fundamental studies presented in this article. Regular and competent self-control by patients allows maintaining normal or close to normal blood glucose levels. It is a reliable, convenient and patient-friendly way to prevent the development of diabetic complications.

Pharmacogenetic Approaches to Enhancing Efficacy and Safety of Statins as Illustrated by the Example of Atorvastatin

Statins are efficacious lipid-lowering drugs used for prevention of cardiovascular complications in patients with high blood cholesterol. The efficacy and safety of this group of drugs is largely determined by genetic factors. The aim of the study was to analyse the effect of gene polymorphisms on the efficacy and safety of atorvastatin in patients undergoing hospital treatment. Materials and methods. The authors carried out a retrospective study of the medical records of 76 hospital patients who were prescribed atorvastatin for confirmed hyperlipidemia. All the patient records contained the results of genotyping of single nucleotide polymorphisms that presumably affect the pharmacokinetics and pharmacodynamics of statins. Results. The analysis of literature data suggested that the pharmacological response and safety of statins could be affected by polymorphisms of the following genes: SLCO1B1 , ABCB1 , CYP2C9 , and CYP2C19 . The study showed that atorvastatin had high efficacy in the carriers of the 3435C allele of the ABCB1 gene and in the carriers of the CYP2C19*2 allele of the CYP2C19 gene. The patients carrying ABCB1 genotypes demonstrated a tendency to increasing levels of low-density lipoproteins and total cholesterol in the following order: 3435 СС → 3435 СТ → 3435 ТТ . The only adverse reaction of atorvastatin in the patient groups was an increase in the activity of hepatic transaminases, however, no connection with the studied gene polymorphisms was observed. Conclusions. The study of the effect of gene polymorphisms on the efficacy and safety of statins will be continued to obtain statistically valid confirmation of the observed trends in a much larger group of patients.

Advantages of modern methods of prevention of thrombotic complications in patients with critical ischemia of lower limbs after reconstructive operations

Aim. To evaluate and improve the results of reconstructive operations in patients with obliterating atherosclerosis with critical ischemia of the lower limbs through reduction of the rate of thrombotic complications by improvement of diagnosis of risk factors for thrombosis on the basis of coagulogram and Thrombodynamics T-2 test data.&#x0D; Materials and Methods. In the I group of patients (n=48) reconstructive operations were performed on the arteries of lower limbs and anticoagulant therapy with unfractionated heparin (UFH) with control of hemostasiogram before the operation, in 6 hours and 6 days after the operation and with additional control of APTT 30 minutes before introduction of UNH. In the II group (n=34) reconstructive operations were performed with selection of anticoagulant therapy using parameters of hemostasiogram and laboratory-diagnostic system Thrombodynamics Recorder T-2 with control before the operation, in 6 hours, 6 days after the operation and with additional control of APTT in 30 minutes before introduction of UFH.&#x0D; Results. Analysis of the data of coagulogram and Thrombodynamics T-2 test showed statistical significance of APTT, fibrinogen, delay and initial speed of clot growth, a combination of which permits a possibility for correction of heparin therapy for prevention of thrombosis.&#x0D; Conclusions. The dynamics of the parameters of Thrombodynamics T-2 test in selection of UFH dose proves high effectiveness of this method for selection of adequate doses of anticoagulant drugs for prevention of postoperative thromboses in patients with critical ischemia of the lower limbs.

临床护理干预对子宫肌瘤患者围术期护理效果及并发症预防分析

临床护理干预对子宫肌瘤患者围术期护理效果及并发症预防分析

Effectiveness of personalized antiplatelet therapy in patients undergoing coronary stenting: meta-analysis

Background . Prevention of complications in patients after coronary stenting by selection of personalized antiplatelet therapy (PAPT) based on platelet function test and genetic analysis have been actively studied. However, it is still an issue of concern. The article presents a meta-analysis of the recent PAPT studies. Aim . To evaluate the effectiveness of personalized antiplatelet therapy in patients undergoing coronary stenting. Methods Fifteen studies with the total of 9,497 patients were included in the meta-analysis. The PAPT studies were searched using the PubMed, Embase and Cochrane Library. Results . PAPT reduces the risk of major adverse cardiovascular events (RR 0.58, 95% CI 0.42-0.80, p = 0.001), stent thrombosis (RR 0.60, 95% CI 0.41-0.87, p = 0.008) and myocardial infarction (RR 0.43, 95% CI 0.21-0.88, p = 0.02) compared with patients without PAPT. However, no significant differences were found in cardiovascular mortality (RR 0.77, 95% CI 0.51-1.16, p = 0.21), bleeding (RR 0.96, 95% CI 0.81-1.13, p = 0.59) and ischemic stroke (RR 0.81, 95% CI 0.39-1.66, p = 0.57). The effectiveness of PAPT in reducing major adverse cardiovascular events was mainly in patients with high platelet reactivity during dual antiplatelet therapy (RR 0.46, 95% CI 0.27-0.80, p = 0.006). Conclusion . Personalized antiplatelet therapy significantly reduces the risk of stent thrombosis, myocardial infarction and other major adverse cardiovascular events in patients with coronary artery stenting.

Adherence to Infectious Disease Screening and Immunization Guidelines When Treating Non-Malignant Immune-Mediated Hematologic Disorders

Background : The use of immunosuppressive therapies in the management of non-malignant immune-mediated hematologic disorders (NMIHD) leads to an increased risk of infections. Preventive strategies, such as immunization and infectious disease (ID) screening, reduce the burden of infectious complications. However, lack of compliance to available guidelines among healthcare providers (HCP) represent a major concern. The present study was performed to assess adherence by HCP to national guidelines and recommendations for the prevention of infectious complications in patients (pts) treated for a NMIHD with the goal to identify areas where interventions can be implemented to improve awareness. Methods : We retrospectively analyzed pts diagnosed with AIHA, acquired coagulation factor deficiency (ACFD), TTP, ITP, aHUS, PNH, and antiphospholipid syndrome (APS) between January 2016 and July 2018 at an academic medical center (University of North Carolina). Pts had to have received either rituximab (RTX), eculizumab, or splenectomy. Adherence to existing strategies was assessed based on available recommendations from recognized national entities (e.g. CDC, ACIP), and clinical societies (e.g. ASH) (summarized in Table 1). Immunizations considered for analysis included: pneumococcal, meningococcal and Haemophilus influenzae vaccines ('triple vaccine' if received all together). We considered 'adherence to an immunization recommendation' when, depending on the diagnosis and treatment employed, pts received all recommended vaccines at least 2 weeks prior to therapy or 4 weeks if splenectomy. Adherence to ID screening in pts receiving RTX therapy was defined as pts screened for both hepatitis B surface antigen and total core antibodies. Influenza virus and herpes zoster (HZ) immunization rates were also analyzed. Results : 269 pts from six UNC-affiliated hospitals were included. Pts clinical characteristics are summarized in Table 2. Overall, only 6% of all evaluable pts were appropriately immunized as recommended by national guidelines (5%, 8%, and 8%, for RTX, eculizumab, and splenectomy, respectively) (Table 3). Immunization rates are summarized in Figure 1. In the eculizumab group, although 92% of HCP recommended and prescribed meningococcal immunization, only 38% (n=5/13) received both vaccines (54% either, 8% none). Likewise, although 89% (n=47/53) of pts undergoing splenectomy had received a 'triple vaccine', only 11% of pts received guideline recommended vaccines (both pneumococcal and meningococcal vaccines) and only 8% were appropriately vaccinated by receiving all indicated vaccines at least 4 weeks prior to their scheduled surgery. 68% of pts treated with RTX were appropriately screened for hepatitis B, with lower rates found in young women (screening rate: 77% age &amp;gt;50 vs. 58% ≤50 years, p&amp;lt;0.01; 83% male vs. 58% female, p&amp;lt;0.01) diagnosed with TTP or APS (ITP 74%, AIHA 79%, ACFD 77% vs. TTP 46%, APS 55%, p=0.01). Lastly, 36% of pts received annual influenza virus vaccine, and 11% of eligible pts the HZ vaccine. Conclusion : To the best of our knowledge, there have been no studies conducted in the U.S. assessing adherence to infectious prevention guidelines among different NMIHD. We found that in pts with NMIHD undergoing immunotherapy or splenectomy, many pts received either incomplete recommended immunizations or the immunization was administered too close in proximity to the immunosuppressive therapy or splenectomy, both resulting in impaired immunologic response to vaccines. In addition, only two thirds of pts receiving RTX had pretreatment screening for hepatitis B infection at odds with national recommendations of 100%. Lastly, low immunization rates against influenza virus and HZ were found. Based on these results, we created infographics (supplemental figure), an "easy-to-use" pocket brochure summarizing recommendations (Table 1), and we are building immunization reminders when electronically prescribing immunotherapy, with the aim of improving HCP awareness in our health care system. Although we are unsure about other institution's compliance rate, we suspect that non-compliance to immunization is a systemic problem across the U.S. We will disseminate this data hoping to replicate this study at other academic institutions. There is an urgent need for the development of strategies to improve HCP awareness and adherence to infectious prevention guidelines! Disclosures No relevant conflicts of interest to declare.