Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 6/2019

01-06-2019 | Brief Research Article

Improvement of appropriate pharmacological prophylaxis in hospitalised cancer patients with a multiscreen e-alert system: a single-centre experience

Authors: R. Figueroa, A. Alfonso, J. López-Picazo, I. Gil-Bazo, A. García-Mouriz, J. Hermida, J. A. Páramo, R. Lecumberri

Published in: Clinical and Translational Oncology | Issue 6/2019

Login to get access

Abstract

Purpose

Thromboprophylaxis use among medical inpatients, including cancer patients, is suboptimal. We aimed to evaluate the impact of a novel multiscreen version (v2.0) of an e-alert system for VTE prevention in hospitalised cancer medical patients compared to the original software.

Methods

Prospective study including 989 consecutive adult cancer patients with high-risk of VTE. Patients were followed-up 30 days post-discharge. Two periods were defined, according to the operative software.

Results

E-alert v2.0 was associated with an increase in the use of LMWH prophylaxis (65.5% vs. 72.0%); risk difference (95% CI) 0.064 (0.0043–0.12). Only 16% of patients in whom LMWH prophylaxis was not prescribed lacked a contraindication. No significant differences in the rates of VTE (2.9% vs. 3.2%) and major bleeding (2.7% vs. 4.0%) were observed.

Conclusions

E-alert v2.0 further increased the use of appropriate thromboprophylaxis in hospitalised cancer patients, although was not associated with a reduction in VTE incidence.
Literature
1.
Spyropoulos AC, Raskob GE. New paradigms in venous thromboprophylaxis of medically ill patients. Thromb Haemost. 2017;117(9):1662–70.CrossRefPubMed
2.
Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients. Cancer. 2007;110(10):2339–46.CrossRefPubMed
3.
Prandoni P, Lensing AW, Piccioli A, Bernardi E, Simioni P, Girolami B, Marchiori A, Sabbion P, Prins MH, Noventa F, Girolami A. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood. 2002;100(10):3484–8.CrossRef
4.
Timp JF, Braekkan SK, Versteeg HH, Cannegieter SC. Epidemiology of cancer-associated venous thrombosis. Blood. 2013;122(10):1712–23.CrossRefPubMed
5.
Kahn SR, Lim W, Dunn AS, Cushman M, Dentali F, Akl EA, Cook DJ, Balekian AA, Klein RC, Le H, Schulman S, Murad MH. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e195S–226S.CrossRefPubMedPubMedCentral
6.
Farge D, Bounameaux H, Brenner B, Cajfinger F, Debourdeau P, Khorana AA, Pabinger I, Solymoss S, Douketis J, Kakkar A. International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer. Lancet Oncol. 2016;17(10):e452–66.CrossRefPubMed
7.
Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar AK, Deslandes B, Huang W, Zayaruzny M, Emery L, Anderson FA Jr, ENDORSE Investigators. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet. 2008;371(9610):387–94.CrossRefPubMed
8.
Amin AN, Stemkowski S, Lin J, Yang G. Inpatient thromboprophylaxis use in U.S. hospitals: adherence to the seventh American College of Chest Physician’s recommendations for at-risk medical and surgical patients. J Hosp Med. 2009;4(8):E15–21.CrossRefPubMed
9.
Kucher N, Koo S, Quiroz R, Cooper JM, Paterno MD, Soukonnikov B, Goldhaber SZ. Electronic alerts to prevent venous thromboembolism among hospitalized patients. N Engl J Med. 2005;352(10):969–77.CrossRefPubMed
10.
Lecumberri R, Marqués M, Díaz-Navarlaz MT, Panizo E, Toledo J, García-Mouriz A, Páramo JA. Maintained effectiveness of an electronic alert system to prevent venous thromboembolism among hospitalized patients. Thromb Haemost. 2008;100(4):699–704.CrossRefPubMed
11.
Lecumberri R, Panizo E, Gomez-Guiu A, Varea S, García-Quetglas E, Serrano M, García-Mouriz A, Marqués M, Gómez-Outes A, Páramo JA. Economic impact of an electronic alert system to prevent venous thromboembolism in hospitalised patients. J Thromb Haemost. 2011;9(6):1108–15.CrossRefPubMed
12.
Lecumberri R, Marqués M, Panizo E, Alfonso A, García-Mouriz A, Gil-Bazo I, Hermida J, Schulman S, Páramo JA. High incidence of venous thromboembolism despite electronic alerts for thromboprophylaxis in hospitalised cancer patients. Thromb Haemost. 2013;110(1):184–90.PubMed
13.
Nieto JA, Cámara T, Camacho I, MEDITROM Investigators. Venous thromboembolism prophylaxis in acutely ill hospitalized medical patients. A retrospective multicenter study. Eur J Intern Med. 2014;25(8):717–23.CrossRefPubMed
14.
Schulman S, Kearon C. Subcommittee on control of anticoagulation of the scientific and standardization committee of the international society on thrombosis and haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost. 2005;3(4):692–4.CrossRef
15.
Zwicker JI, Rojan A, Campigotto F, Rehman N, Funches R, Connolly G, Webster J, Aggarwal A, Mobarek D, Faselis C, Neuberg D, Rickles FR, Wun T, Streiff MB, Khorana AA. Pattern of frequent but nontargeted pharmacologic thromboprophylaxis for hospitalized patients with cancer at academic medical centers: a prospective, cross-sectional, multicenter study. J Clin Oncol. 2014;32(17):1792–6.CrossRefPubMedPubMedCentral
16.
Panizo E, Alfonso A, García-Mouriz A, López-Picazo JM, Gil-Bazo I, Hermida J, Páramo JA, Lecumberri R. Factors influencing the use of thromboprophylaxis in cancer outpatients in clinical practice: a prospective study. Thromb Res. 2015;136(6):1145–8.CrossRefPubMed
17.
Flanders SA, Greene MT, Grant P, Kaatz S, Paje D, Lee B, Barron J, Chopra V, Share D, Bernstein SJ. Hospital performance for pharmacologic venous thromboembolism prophylaxis and rate of venous thromboembolism: a cohort study. JAMA Intern Med. 2014;174(10):1577–84.CrossRefPubMed
18.
Kucher N, Spirk D, Baumgartner I, Mazzolai L, Korte W, Nobel D, Banyai M, Bounameaux H. Lack of prophylaxis before the onset of acute venous thromboembolism among hospitalized cancer patients: the SWIss Venous ThromboEmbolism Registry (SWIVTER). Ann Oncol. 2010;21(5):931–5.CrossRefPubMed
Metadata
Title
Improvement of appropriate pharmacological prophylaxis in hospitalised cancer patients with a multiscreen e-alert system: a single-centre experience
Authors
R. Figueroa
A. Alfonso
J. López-Picazo
I. Gil-Bazo
A. García-Mouriz
J. Hermida
J. A. Páramo
R. Lecumberri
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 6/2019
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-018-1986-1

Other articles of this Issue 6/2019

Clinical and Translational Oncology 6/2019 Go to the issue

Research Article

Metronomic oral vinorelbine for the treatment of advanced non-small cell lung cancer: a multicenter international retrospective analysis

Research Article

Health-related quality of life analysis in stage III melanoma patients treated with adjuvant dendritic cell therapy

Review Article

The dual effect of morphine on tumor development

Review Article

Programmed cell death protein-1 (PD-1)/programmed death-ligand-1 (PD-L1) axis in hepatocellular carcinoma: prognostic and therapeutic perspectives

Research Article

Omitting the lower neck and sparing the glottic larynx in node-negative nasopharyngeal carcinoma was safe and feasible, and improved patient-reported voice outcomes

Brief Research Article

Statin treatment and outcomes of metastatic pancreatic cancer: a pooled analysis of two phase III studies
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits