Background: Hospital-associated venous thromboembolism (HA-VTE) is a serious condition with controversy regarding ideal risk assessment and VTE prophylaxis (VTEP), especially in medical patients. We conducted a collaborative VTE quality improvement project, supported by a charitable grant from the Gordon and Betty Moore Foundation, in 35 hospitals across three states and assessed the impact on HA-VTE [...]

Background: Peripherally inserted central catheters (PICCs) have been associated with venous thromboembolism (VTE) and are a major cause of upper extremity deep vein thrombosis (DVT).  However, mechanisms to identify patients at greatest risk of PICC-associated VTE are limited. Methods:  Using data from the Michigan Hospital Medicine Safety consortium, patients with PICCs that experienced symptomatic, image-confirmed [...]

Background: Peripherally inserted central catheters (PICCs) have been associated with venous thromboembolism (VTE) and are a major cause of upper extremity deep vein thrombosis (DVT).  However, mechanisms to identify patients at greatest risk of PICC-associated VTE are limited. Methods:  Using data from the Michigan Hospital Medicine Safety consortium, patients with PICCs that experienced symptomatic, image-confirmed [...]

Background: Hospital-associated venous thromboembolism (HA-VTE) is a serious condition with controversy regarding ideal risk assessment and VTE prophylaxis (VTEP), especially in medical patients. We conducted a collaborative VTE quality improvement project, supported by a charitable grant from the Gordon and Betty Moore Foundation, in 35 hospitals across three states and assessed the impact on HA-VTE [...]

Background: Recent guidelines include aspirin as an option to prevent venous thromboembolism (VTE) in selected patients undergoing hip or knee replacement surgery. However, the efficacy of aspirin after arthroplasty has not been well-defined, particularly in more contemporary patient populations. Objective: To compare rates of post-operative VTE between patients who received aspirin-only versus anticoagulants after hip [...]

Background: Guidelines for peripherally inserted central catheters (PICCs) recommend avoiding insertion if the anticipated use is 5 or fewer days.  However, short-term PICC use is common in hospitals. We sought to identify patient-, provider- and device-characteristics associated with short-term PICC use. Methods: Between January 2014 and June 2016, trained abstractors at each of 51 Michigan [...]

Background: Prophylactic anticoagulation is effective at reducing the risk of venous thromboembolism (VTE), but can also increase the risk of bleeding. Whether anticoagulant prophylaxis should be modified for underweight patients to minimize bleeding complications is unknown.  We sought to determine whether being underweight is associated with the risk of major bleeding in hospitalized medical patients [...]

Background: Multi-lumen (ML) peripherally inserted central catheters (PICCs) are associated with increased risk of central line associated blood stream infection (CLABSI), venous thromboembolism (VTE) and increased cost compared to single lumen (SL) PICCs. Current guidelines recommend minimizing the number of PICC lumens. However, there is a paucity of literature to guide the selection of SL [...]

Background: Chemoprophylaxis with subcutaneous heparin or low-molecular weight heparin is recommended for venous thromboembolism (VTE) prevention in appropriate medical patients.  However, all doses are not always administered and the consequences are unclear.  We sought to determine if there is a relationship between missed and/or refused doses and development of in-hospital VTEs. Methods: The study is [...]

Background: Compared with patients in the community, patients acutely hospitalized are at higher risk of developing venous thromboembolism (VTE), contributing to patient morbidity and mortality and healthcare costs. The need for thromboprophylaxis for post-surgical patients is well-known and the importance of thromboprophylaxis for acutely-ill hospitalized medicine patients has been increasingly accepted. We aimed to analyze [...]