Background: Patients with end stage renal disease (ESRD) are at significantly increased risk for both thrombosis and bleeding relative to those with normal renal function, which makes anticoagulation particularly challenging. Evidence suggests that rivaroxaban and dabigatran are associated with a higher risk of bleeding in ESRD patients. To date, no large national cohort studies have […]

Background: Multiple factors can lead to overuse of diagnostic imaging for venous thromboembolism (VTE). These include fear of missing a potentially fatal diagnosis, low predictive accuracy of clinical gestalt, prediction rules, and risk assessment models for VTE, and increased access to imaging. Diagnostic imaging for deep venous thrombosis (DVT) with doppler ultrasonography, or for pulmonary […]

Background: International VTE management guidelines recommend outpatient management for appropriate patients with low-risk deep vein thrombosis (DVT) or pulmonary embolism (PE)[1-3]. Despite the evidence and recommendations, previous studies reported low prevalence of outpatient management, especially for PE[4, 5]. This analysis aimed to characterize trends in outpatient vs. inpatient management of VTE in the last 5 […]

Background: Acutely ill hospitalized medicine patients are at increased risk for venous thromboembolism (VTE) and chemoprophylaxis of VTE is recommended for this patient population. Agents typically used for VTE chemoprophylaxis include unfractionated heparin and low molecular weight heparin (LMWH) administered via subcutaneous injection one to three times daily. Over the past decade, new evidence is […]

Background: High rates of venous thromboembolism (VTE) have been reported with coronavirus disease 2019 (Covid-19). However, studies have predominantly focused on hospitalized patients. The risk of VTE in outpatients with Covid-19 is less known. Methods: We conducted an observational study of adults (age ≥18 years) enrolled in two large, integrated healthcare delivery systems serving >9 […]

Background: Symptomatic venous thromboembolism (VTE) occurs in about 1% of patients within 3 months after admission to a medicine ward.1,2 The 9th Edition American College of Chest Physicians Guidelines recommends the use of pharmacologic VTE prophylaxis in acutely ill hospitalized medical patients at increased risk of thrombosis and suggests against its use in low risk […]