Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question
Background: Thrombophilia tests are often ordered unnecessarily and/or inappropriately, with significant impact on healthcare costs, hospital resources, time, and potential harm to the patient. Objective: To identify the incidence of unnecessary and inappropriate thrombophilia testing in a community...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Greater Baltimore Medical Center
2019-09-01
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| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20009666.2019.1655627 |
| _version_ | 1828075553536606208 |
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| author | Ashish Gupta Poras Patel Raheel Anwar Diana Villanueva Viswanath Vasudevan Elizabeth Guevara |
| author_facet | Ashish Gupta Poras Patel Raheel Anwar Diana Villanueva Viswanath Vasudevan Elizabeth Guevara |
| author_sort | Ashish Gupta |
| collection | DOAJ |
| description | Background: Thrombophilia tests are often ordered unnecessarily and/or inappropriately, with significant impact on healthcare costs, hospital resources, time, and potential harm to the patient. Objective: To identify the incidence of unnecessary and inappropriate thrombophilia testing in a community hospital setting. Methods: We retrospectively reviewed electronic medical records for patients who underwent inpatient thrombophilia testing at The Brooklyn Hospital Center from 1/1/2018 to 12/31/2018. The indications, and details of the tests, and associated costs were recorded. Results: A total of 62 patients were included (mean age 45.8, 67.7% female). In 57/62 (91.9%) patients, tests were ordered in the acute phase of thrombosis. At the time the tests were ordered, 29/62 (46.8%) patients were on anticoagulation. Positive results were found in 21/62 (53.2%) patients, but was repeated in only 1/21 (4.7%) patient. Results for 51/62 (82%) patients were obtained after discharge. The hematology-oncology service was consulted in 5/62 (8.1%) cases and recommended testing in only 1 (1.6%) patient. Only 1 (1.6%) patient had both an appropriate indication and appropriate testing. Costs for the 273 total tests were $26,400. Conclusion: Thrombophilia tests were often ordered inappropriately and unnecessarily. We recommend testing only for patients with inpatient status under recommendation from the hematology-oncology service. |
| first_indexed | 2024-04-11T01:59:52Z |
| format | Article |
| id | doaj.art-a816aecff0194a8c9b942c3dfb6d3f1d |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T01:59:52Z |
| publishDate | 2019-09-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-a816aecff0194a8c9b942c3dfb6d3f1d2023-01-03T04:19:26ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662019-09-019539239610.1080/20009666.2019.16556271655627Hypercoagulable workup in a community hospital setting: to test or not to test; that is the questionAshish Gupta0Poras Patel1Raheel Anwar2Diana Villanueva3Viswanath Vasudevan4Elizabeth Guevara5Brooklyn Hospital CenterBrooklyn Hospital CenterBrooklyn Hospital CenterBrooklyn Hospital CenterBrooklyn Hospital CenterBrooklyn Hospital CenterBackground: Thrombophilia tests are often ordered unnecessarily and/or inappropriately, with significant impact on healthcare costs, hospital resources, time, and potential harm to the patient. Objective: To identify the incidence of unnecessary and inappropriate thrombophilia testing in a community hospital setting. Methods: We retrospectively reviewed electronic medical records for patients who underwent inpatient thrombophilia testing at The Brooklyn Hospital Center from 1/1/2018 to 12/31/2018. The indications, and details of the tests, and associated costs were recorded. Results: A total of 62 patients were included (mean age 45.8, 67.7% female). In 57/62 (91.9%) patients, tests were ordered in the acute phase of thrombosis. At the time the tests were ordered, 29/62 (46.8%) patients were on anticoagulation. Positive results were found in 21/62 (53.2%) patients, but was repeated in only 1/21 (4.7%) patient. Results for 51/62 (82%) patients were obtained after discharge. The hematology-oncology service was consulted in 5/62 (8.1%) cases and recommended testing in only 1 (1.6%) patient. Only 1 (1.6%) patient had both an appropriate indication and appropriate testing. Costs for the 273 total tests were $26,400. Conclusion: Thrombophilia tests were often ordered inappropriately and unnecessarily. We recommend testing only for patients with inpatient status under recommendation from the hematology-oncology service.http://dx.doi.org/10.1080/20009666.2019.1655627thrombophiliavenous thrombosishypercoagulability testing |
| spellingShingle | Ashish Gupta Poras Patel Raheel Anwar Diana Villanueva Viswanath Vasudevan Elizabeth Guevara Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question Journal of Community Hospital Internal Medicine Perspectives thrombophilia venous thrombosis hypercoagulability testing |
| title | Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question |
| title_full | Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question |
| title_fullStr | Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question |
| title_full_unstemmed | Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question |
| title_short | Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question |
| title_sort | hypercoagulable workup in a community hospital setting to test or not to test that is the question |
| topic | thrombophilia venous thrombosis hypercoagulability testing |
| url | http://dx.doi.org/10.1080/20009666.2019.1655627 |
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