Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]

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: Venous thromboembolism (VTE) is the leading cause of preventable hospital death. National guidelinesrecommend VTE prophylaxis for all medical patients not at low risk. Several VTE risk prediction models have been developed, but no US models have been validated in a medical population. The ACCP recommends use of the Padua risk assessment model with a [...]

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 [...]

Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]

Background: Venous thromboembolism (VTE) is the leading cause of preventable hospital death. National guidelinesrecommend VTE prophylaxis for all medical patients not at low risk. Several VTE risk prediction models have been developed, but no US models have been validated in a medical population. The ACCP recommends use of the Padua risk assessment model with a [...]

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: Pulmonary embolism (PE) and atrial fibrillation (AF) may coexist. The association and impact of AF on PE have not been well studied. Methods: We queried the 2018 National Inpatient Sample (NIS) database to identify PE and AF hospitalizations using appropriate ICD-10 codes. PE with AF group was compared to PE without AF. Chi-square test [...]

Background: The direct oral anticoagulants (DOACs) apixaban and rivaroxaban are increasingly prescribed due to convenient oral formulation without the need for routine laboratory monitoring and are now commonly regarded as first line anticoagulants in most cases of venous thromboembolism (VTE). However, the optimal choice of subsequent anticoagulant in instances of first line DOAC failure is [...]