Refusal of Venous Thromboembolism Prophylaxis and Incidence of Thrombosis in Patients with Cystic Fibrosis.
Patients in the hospital are at an increased risk of developing a deep vein thrombosis or pulmonary embolism. Some risk factors including recent surgery, vascular injury, or hypercoagulability increase a patient’s risk for a venous thromboembolism; however, these events can occur in patients without risk factors, as well.
The reported rate of VTE in medically ill patients is 10-26%. Due to this risk, it is
important for all acutely ill, hospitalized patients to receive pharmacologic or mechanical prophylaxis, to avoid a preventable VTE from occurring.
Venous thromboembolism prophylaxis is considered a core measure by The Joint Commission and
Centers for Medicare and Medicaid Services for all patients older than 18 years of age and with a
hospitalization length of stay at least 2 days.
Pharmacologic prophylaxis has demonstrated the potential to reduce VTE events by 50-65% in acutely ill patients with a favorable safety profile. Patients with cystic fibrosis are frequently hospitalized for intravenous antibiotics due to persistent pulmonary infections and difficulty in eradicating pulmonary bacterial colonization. These patients, similar to other acutely ill medical patients, have an 8-fold increased risk of VTE.
Some common risk factors among acute medically ill patients and those with CF include decreased respiratory function and decreased mobility. Additional VTE risk factors identified for patients with CF include the presence of central venous catheters, colonization with Burkholderia cepacia complex, ongoing inflammation, liver dysfunction, platelet hyper-reactivity and vitamin K deficiency.
Pulm Res Respir Med Open J. 2017; 4(2): 42-47. doi: 10.17140/PRRMOJ-4-138
