Document Detail

Evidence-based venous thromboembolism prophylaxis is associated with a six-fold decrease in numbers of symptomatic venous thromboembolisms in rehabilitation inpatients.
MedLine Citation:
PMID:  22192320     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To measure the impact of a standardized risk assessment tool and specialty-specific, risk-adjusted venous thromboembolism (VTE) order sets on compliance with American College of Chest Physicians (ACCP) guidelines and the number of symptomatic VTE as assessed by administrative data.
DESIGN: Prospective cohort study.
SETTING: Academic hospital inpatient rehabilitation unit.
PATIENTS AND PARTICIPANTS: All patients on the rehabilitation unit.
METHODS AND INTERVENTIONS: Assessment of VTE risk factors and evaluated admission VTE prophylaxis orders before and after implementation of an ACCP guideline-based, specialty-specific VTE risk assessment, and prophylaxis order set by using a standardized data collection form.
MAIN OUTCOME MEASURES: Discharge diagnostic codes for VTE and pulmonary embolism were tracked by ICD-9 (International Classification of Diseases, 9th edition) discharge diagnosis codes for the 12 months before and 36 months after the intervention.
RESULTS: Before implementation of the VTE order set, 27% of patients received VTE prophylaxis in compliance with the 2004 ACCP VTE guidelines. By following implementation of specialty-specific, risk-adjusted VTE order sets, compliance increased to 98%. In the year before VTE order-set implementation, the number of VTEs per admission was 49 per 1000. By following implementation, the number of VTEs steadily decreased each year to 8 per 1000 in 2007 (χ(2) = 14.985; P = .0001).
CONCLUSIONS: Implementation of a standardized VTE risk assessment tool and prophylaxis order set resulted in a substantial improvement in compliance with ACCP guidelines for VTE prophylaxis and was associated with a 6-fold reduction in the number of symptomatic VTEs in a hospital-based rehabilitation unit.
R Samuel Mayer; Michael B Streiff; Deborah B Hobson; Daniel E Halpert; Sean M Berenholtz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  PM & R : the journal of injury, function, and rehabilitation     Volume:  3     ISSN:  1934-1563     ISO Abbreviation:  PM R     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-23     Completed Date:  2012-05-07     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  101491319     Medline TA:  PM R     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1111-1115.e1     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21208, USA.
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MeSH Terms
Aged, 80 and over
Guideline Adherence / statistics & numerical data
Hospitalization / statistics & numerical data
Middle Aged
Prospective Studies
Rehabilitation Centers
Risk Assessment
Risk Factors
Venous Thromboembolism / epidemiology,  prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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