Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage

Background A venous thromboembolism (VTE) bundle was launched in 2016 at the University of Illinois Hospital aiming to reduce the rate of VTE in the neurosurgical ICU. Main elements of the bundle included correct and early use of intermittent pneumatic compression and subcutaneous heparin. Methods P...

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Main Authors: Brian Phan PharmD, BCCCP, Lolita Fagaragan MS, SCRN, Ali Alaraj MD, Keri S. Kim PharmD, MS CTS, BCPS
Format: Article
Language:English
Published: SAGE Publishing 2022-01-01
Series:Clinical and Applied Thrombosis/Hemostasis
Online Access:https://doi.org/10.1177/10760296221074682
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author Brian Phan PharmD, BCCCP
Lolita Fagaragan MS, SCRN
Ali Alaraj MD
Keri S. Kim PharmD, MS CTS, BCPS
author_facet Brian Phan PharmD, BCCCP
Lolita Fagaragan MS, SCRN
Ali Alaraj MD
Keri S. Kim PharmD, MS CTS, BCPS
author_sort Brian Phan PharmD, BCCCP
collection DOAJ
description Background A venous thromboembolism (VTE) bundle was launched in 2016 at the University of Illinois Hospital aiming to reduce the rate of VTE in the neurosurgical ICU. Main elements of the bundle included correct and early use of intermittent pneumatic compression and subcutaneous heparin. Methods Patients with SAH were retrospectively identified from 2014 until 2018. VTE events were diagnosed using twice weekly lower-extremity venous Duplex ultrasound and chest computerized tomography when appropriate. Results A total of 133 patients was included in each group. The incidence of VTE was not significantly different before and after the bundle (15% vs. 12%, p = 0.47). No difference was found regarding new episode of intracranial hemorrhage secondary to SQH (1.5% vs. 2.1%, p = 0.65). Multivariate analysis demonstrated that longer ICU LOS, higher Caprini score, and presence of baseline lung diseases were associated with VTE development. Conclusions With a median Caprini score of 9, our patient population was found to be at high risk for developing VTE. The implementation of the VTE bundle did not significantly reduce the rate of VTE in patients with non-traumatic SAH at UIH.
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spelling doaj.art-572ecc6684984e11ad61fecfb8a4a6cb2022-12-21T21:36:07ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232022-01-012810.1177/10760296221074682Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid HemorrhageBrian Phan PharmD, BCCCP0Lolita Fagaragan MS, SCRN1Ali Alaraj MD2Keri S. Kim PharmD, MS CTS, BCPS3 , Moreno Valley, California, USA , Chicago, Illinois, USA , Chicago, Illinois, USA , Chicago, Illinois, USABackground A venous thromboembolism (VTE) bundle was launched in 2016 at the University of Illinois Hospital aiming to reduce the rate of VTE in the neurosurgical ICU. Main elements of the bundle included correct and early use of intermittent pneumatic compression and subcutaneous heparin. Methods Patients with SAH were retrospectively identified from 2014 until 2018. VTE events were diagnosed using twice weekly lower-extremity venous Duplex ultrasound and chest computerized tomography when appropriate. Results A total of 133 patients was included in each group. The incidence of VTE was not significantly different before and after the bundle (15% vs. 12%, p = 0.47). No difference was found regarding new episode of intracranial hemorrhage secondary to SQH (1.5% vs. 2.1%, p = 0.65). Multivariate analysis demonstrated that longer ICU LOS, higher Caprini score, and presence of baseline lung diseases were associated with VTE development. Conclusions With a median Caprini score of 9, our patient population was found to be at high risk for developing VTE. The implementation of the VTE bundle did not significantly reduce the rate of VTE in patients with non-traumatic SAH at UIH.https://doi.org/10.1177/10760296221074682
spellingShingle Brian Phan PharmD, BCCCP
Lolita Fagaragan MS, SCRN
Ali Alaraj MD
Keri S. Kim PharmD, MS CTS, BCPS
Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage
Clinical and Applied Thrombosis/Hemostasis
title Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage
title_full Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage
title_fullStr Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage
title_full_unstemmed Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage
title_short Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage
title_sort multidisciplinary bundle approach in venous thromboembolism prophylaxis in patients with non traumatic subarachnoid hemorrhage
url https://doi.org/10.1177/10760296221074682
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