Venous Thromboembolism (VTE) Prophylaxis Regimens in Obese Patients Lauren Strange, Chris Larkin, Kelley Baxter, Robin Tagatz St. Thomas Hospital - Nashville, TN
Background/Purpose: Evaluate VTE prophylaxis regimens in hospitalized patients, with and without hospital-acquired VTE who have a BMI greater than or equal to 40.
Methodology: Retrospective chart review including patients greater than or equal to 18 years old with a BMI greater than or equal to 40. Electronic medical records were reviewed for patients who received at least one dose of a pharmacologic agent used for VTE prophylaxis. Patients were divided into two groups for evaluation: patients who developed VTE and those who did not. Patients were evaluated based on the Patient Safety Indicators -12 criteria (PSI-12), which was modified to include surgical and non-surgical patients. Data was analyzed using the Chi-Square test.
Results: Forty-three patients were included in this IRB-approved study. The age of patients ranged from 55-60 years old with a BMI of 48. There was only one dose adjustment (8%) for obesity in the VTE group, and three dose adjustments (10%) in the non-VTE group.
Conclusions: There were very few dose adjustments for obesity between the two comparison groups. There was no difference in the rate of VTE in obese patients with FDA-labeled prophylactic doses of enoxaparin or heparin versus adjusted doses of enoxaparin or heparin. The lack of dose adjustments could be due to the limited literature to support adjusting the dose. The small number of patients with adjusted doses of VTE prophylaxis for obesity demonstrates that opportunities may exist for intervention to increase the intensity of pharmacologic prophylaxis. This study_x0019_s main limitation was that it was underpowered.
Presentation Objective: To evaluate VTE prophylaxis regimens in hospitalized patients, with and without hospital-acquired VTE who have a BMI greater than or equal to 40.
Self-Assessment: Should pharmacologic prophylaxis be changed in obese patients?
