Gender differences in the administration of prophylaxis to prevent deep venous thrombosis

Nils Kucher; Victor F. Tapson; Rene Quiroz; Samy S. Mir; Ruth B. Morrison; David McKenzie; Samuel Z. Goldhaber; for the DVT FREE Steering Committee

doi:10.1160/TH04-08-0513

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(02): 284-288
DOI: 10.1160/TH04-08-0513

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Gender differences in the administration of prophylaxis to prevent deep venous thrombosis

Nils Kucher

¹Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

Victor F. Tapson

²Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA

,

Rene Quiroz

¹Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

Samy S. Mir

¹Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

Ruth B. Morrison

¹Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

David McKenzie

³Quintiles, Inc., Kansas City, Missouri, USA

,

Samuel Z. Goldhaber

¹Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

for the DVT FREE Steering Committee

› Author Affiliations

Abstract

Summary

We investigated gender differences in the prescription of prophylaxis against deep vein thrombosis (DVT) in 2,619 patients who developed acute DVT while being hospitalized for reasons other than DVT or were diagnosed with acute DVT as outpatients but who had been hospitalized within 30 days prior to DVT diagnosis. Men were 21% more likely than women to receive prophylaxis (OR 1.21, 95% CI 1.03–1.43; p = 0.021) after adjusting for DVT risk factors, including surgery, trauma, prior DVT, age, and cancer.

Keywords

Prophylaxis - deep vein thrombosis - gender

Full Text

References

References
1 White RH. The epidemiology of venous thromboembolism.. Circulation 2003; 107 (23) (Suppl. 01) I4-8.
2 Nicolaides AN, Breddin HK, Fareed J. et al Prevention of venous thromboembolism. International Consensus Statement. Guidelines compiled in accordance with the scientific evidence.. Int Angiol 2001; 20: 1-37.
3 Geerts WH, Pineo GF, Heit JA. et al Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.. Chest 2004; 126: 338S-400S.
4 Arnold DM, Kahn SR, Shrier I. Missed opportunities for prevention of venous thromboembolism: an evaluation of the use of thromboprophylaxis guidelines.. Chest 2001; 120: 1964-71.
5 Bratzler DW, Raskob GE, Murray CK. et al Underuse of venous thromboembolism prophylaxis for general surgery patients: physician practices in the community hospital setting.. Arch Intern Med 1998; 158: 1909-12.
6 Otero R, Uresandi F, Cayuela A. et al Use of venous thromboembolism prophylaxis for surgical patients: a multicentre analysis of practice in Spain.. Eur J Surg 2001; 167: 163-7.
7 Hollyoak M, Woodruff P, Muller M. et al Deep venous thrombosis in postoperative vascular surgical patients: a frequent finding without prophylaxis.. J Vasc Surg 2001; 34: 656-60.
8 Ryskamp RP, Trottier SJ. Utilization of venous thromboembolism prophylaxis in a medical-surgical ICU.. Chest 1998; 113: 162-4.
9 Egermayer P, Robins C, Town GI. Survey of the use of thromboprophylaxis for medical patients at Christchurch Hospital.. N Z Med J 1999; 112: 246-8.
10 Goldhaber SZ, Dunn K, MacDougall RC. New onset of venous thromboembolism among hospitalized patients at Brigham and Women's Hospital is caused more often by prophylaxis failure than by withholding treatment.. Chest 2000; 118 (06) 1680-4.
11 Wong CC, Froelicher ES, Bacchetti P. et al Influence of gender on cardiovascular mortality in acute myocardial infarction patients with high indication for coronary angiography.. Circulation 1997; 96 (9 Suppl) II 51-7.
12 Kindwall KE. Therapy for coronary heart disease in women.. Cardiovasc Clin 1989; 19 (03) 195-203.
13 Maynard C, Litwin PE, Martin JS. et al Gender differences in the treatment and outcome of acute myocardial infarction. Results from the Myocardial Infarction Triage and Intervention Registry.. Arch Intern Med 1992; 152 (05) 972-6.
14 Chandra NC, Ziegelstein RC, Rogers WJ. et al Observations of the treatment of women in the United States with myocardial infarction: a report from the National Registry of Myocardial Infarction-I.. Arch Intern Med 1998; 158 (09) 981-8.
15 Gan SC, Beaver SK, Houck PM. et al Treatment of acute myocardial infarction and 30-day mortality among women and men.. N Engl J Med 2000; 343 (01) 8-15.
16 Goldhaber SZ, Tapson VF. for the DVT FREE Steering Committee. A prospective registry of 5451 patients with ultrasound-confirmed deep vein thrombosis. Am J Cardiol 2004; 93: 259-62.
17 Anderson Jr. FA, Wheeler HB, Goldberg RJ. et al Physician practices in the prevention of venous thromboembolism.. Ann Intern Med 1991; 115 (08) 591-5.
18 Alikhan R, Cohen AT, Combe S. et al Prevention of venous thromboembolism in medical patients with enoxaparin: a subgroup analysis of the MEDENOX study.. Blood Coagul Fibrinolysis 2003; 14 (04) 341-6.
19 Bauer KA, Eriksson I B, Lassen MR. et al Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after elective major knee surgery.. N Engl J Med 2001; 345 (18) 1305-10.
20 Eriksson BI, Bauer KA, Lassen MR. et al Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery.. N Engl J Med 2001; 345 (18) 1298-304.
21 Lassen MR, Bauer KA, Eriksson BI. et al Postoperative fondaparinux versus preoperative enoxaparin for prevention of venous thromboembolism in elective hip-replacement surgery: a randomised double-blind comparison.. Lancet 2002; 359 9319 1715-20.
22 Leizorovicz A, Cohen AT, Turpie AG. et al Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients.. Circulation 2004; 110 (07) 874-9.