Indeed, a previous study showed that almost all patients in a critical care unit had at least one major VTE risk factor, and a large proportion had multiple factors. Patients in the intensive care unit (ICU) are at increased risk for venous thromboembolism (VTE), the most common preventable cause of hospital death in the United States, because of their risk factors, including immobility, frequency of endothelial injury from trauma and surgical procedures, and an increased likelihood of underlying disorders related to thrombophilic states. However, when examining pharmacologic prophylaxis specifically, the rate was considerably lower than is currently recommended: 54% among the trauma services and 44% among non-trauma services. Overall, the receipt of VTE prophylaxis of any type was close to 100%, due to the nearly universal use of mechanical compression devices among ICU patients in this study. Trauma-service admission (OR = 8.30, 95% CI 2.18–31.56) and increasing hospital length of stay (OR = 1.15, 95% CI 1.03–1.28) were independently associated with delayed prophylaxis initiation. In regression analyses, trauma-service admission (odds ratio (OR) = 2.88, 95% confidence interval (CI) 1.21–6.83) and increasing ICU length of stay (OR = 1.13, 95% CI 1.05–1.21) were independently associated with pharmacologic prophylaxis use. The median time from ICU admission to pharmacologic prophylaxis initiation was 53 h for the trauma service and 10 h for the non–trauma services ( P ≤ 0.01). 44%, P = 0.16) prophylaxis rates were similar between the two admission groups. One-hundred two study participants were admitted by the trauma service, and 98 were from a non-trauma service. Root causes for opting out of pharmacological prophylaxis were documented and compared between the two study groups. Prophylaxis administration practices, including administration of mechanical and/or pharmacologic prophylaxis and delayed (≥48 h post-ICU admission) initiation of pharmacologic prophylaxis, were compared between patients admitted to the ICU by the trauma service versus other departments. Patients were excluded if they had instructions to receive comfort measures only or required therapeutic anticoagulant administration. ![]() This was a retrospective cohort study on all patients aged 18+ admitted to an open ICU between and. ![]() In those intensive care units (ICUs) where patient care is more uniformly directed, it may be expected that VTE prophylaxis would more closely follow this standard over units that are less uniform, such as open-model ICUs. Recommendations are for nearly universal venous thromboembolism (VTE) prophylaxis in critically ill hospitalized patients because of their well-recognized risks.
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