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: D-dimer is clinically useful for its high sensitivity and negative predictive value as a useful “rule out” test for venous thromboembolism. Nevertheless, the D-dimer assay is not specific and often elevated in states of systemic inflammation or illness.Stasis of blood flow, Endothelial injury, and hypercoagulability are the tenets of thrombus formation. When any one [...]

Background: We previously found that red blood cell (RBC) transfusion was a trigger for hospitalization for venous thromboembolism (VTE) in a Medicare population. As peripherally inserted central catheters (PICCs) are both associated with VTE and often used for RBC transfusion, we assessed the prevalence of VTE in patients with PICCs. Methods: We used data from [...]

Background: Venous thromboembolism, in particular, pulmonary embolism (PE), is a significant contributor to morbidity and mortality associated with COVID-19. In comparison to influenza, COVID-19 leads to a more pronounced hypercoagulable state secondary to endotheliopathy and hyperinflammatory state which results in the formation of venous and arterial thrombosis. Based on prior literature, patients with COVID-19 have [...]

Background: The Choosing Wisely campaign discourages CT imaging in low-risk patients with suspected pulmonary embolism (PE) (e.g., low clinical probability and negative d-dimer). Few studies have investigated patient, provider, or operational characteristics associated with overuse of CT imaging. One possible approach to this research question is to examine variability in diagnostic yield (i.e., the percentage [...]

Background: Vitamin K antagonists (VKA) remain widely used in the treatment of venous thromboembolism (VTE). During surgical interventions, the prevention of recurrent VTE must be weighed against the increased bleeding risk conferred by anticoagulation. There is a lack of strong evidence to guide the optimal periprocedural management of anticoagulation in patients with prior VTE, and [...]

Background: Bisphosphonates are the most commonly prescribed medications for treatment for osteoporosis (OP). Although increasing evidence supports a good safety profile, there is an emerging concern regarding the cardiovascular safety of these agents. Whereas the association with superficial phlebitis has been well documented, the risk of VTE is still not established. Limited data exist on [...]

Background: For peripherally compatible infusates planned for