Table 1.
Patient and Hospital Characteristics Associated with Early VTE Prophylaxis
| Total | Early prophylaxis (by Day 2) | ||||
|---|---|---|---|---|---|
| Predictors | N | Column % | N | Row % | p-value |
| 351,535 | 100.0 | 125,433 | 35.7 | ||
| Demographics | |||||
| Age | <0.001 | ||||
| 18–49 | 38,773 | (11.0) | 12,457 | (32.1) | |
| 50–64 | 69,311 | (19.7) | 26,582 | (38.4) | |
| 65–79 | 123,387 | (35.1) | 46,069 | (37.3) | |
| 80+ | 120,064 | (34.2) | 40,325 | (33.6) | |
| Gender | <0.001 | ||||
| Male | 147,910 | (42.1) | 54,211 | (36.7) | |
| Female | 203,616 | (57.9) | 71,218 | (35.0) | |
| Race | <0.001 | ||||
| White | 231,184 | (65.8) | 81,739 | (35.4) | |
| Black | 55,712 | (15.8) | 22,517 | (40.4) | |
| Hispanic | 13,745 | (3.9) | 4,742 | (34.5) | |
| Other | 50,894 | (14.5) | 16,435 | (32.3) | |
| Primary diagnosis | <0.001 | ||||
| Community-acquired pneumonia | 108,639 | (30.9) | 33,098 | (30.5) | |
| Septicemia | 11,576 | (3.3) | 4,494 | (38.8) | |
| Chronic obstructive pulmonary disease | 45,888 | (13.1) | 15,152 | (33.0) | |
| Respiratory failure | 13,015 | (3.7) | 8,007 | (61.5) | |
| Congestive heart failure | 85,222 | (24.2) | 36,359 | (42.7) | |
| Stroke | 49,557 | (14.1) | 20,656 | (41.7) | |
| Urinary tract infection | 37,638 | (10.7) | 7,667 | (20.4) | |
| Attending specialty | <0.001 | ||||
| Internist | 190,284 | (54.1) | 70,459 | (37.0) | |
| GP/family medicine | 71,765 | (20.4) | 19,118 | (26.6) | |
| Cardiologist | 25,508 | (7.3) | 10,467 | (41.0) | |
| Pulmonologist | 21,009 | (6.0) | 8,955 | (42.6) | |
| Nephrology | 8,522 | (2.4) | 2,521 | (29.6) | |
| Other | 34,447 | (9.8) | 13,913 | (40.4) | |
| Insurance payor | <0.001 | ||||
| Medicare traditional | 235,033 | (66.9) | 82,534 | (35.1) | |
| Medicare-managed care | 16,347 | (4.7) | 6,477 | (39.6) | |
| Medicaid | 23,120 | (6.6) | 8,511 | (36.8) | |
| Private | 61,505 | (17.5) | 22,388 | (36.4) | |
| Self-pay/uninsured/other | 15,530 | (4.4) | 5,523 | (35.6) | |
| Risk factors for VTE | |||||
| Admitted from skilled nursing facility | 4,460 | (1.3) | 1,523 | (34.1) | 0.03 |
| Paralysis | 25,311 | (7.2) | 10,770 | (42.6) | <0.001 |
| Restraints | 4,759 | (1.4) | 2,690 | (56.5) | <0.001 |
| Decubitus ulcer | 10,591 | (3.0) | 4,143 | (39.1) | <0.001 |
| Cancer | 48,180 | (13.7) | 16,527 | (34.3) | <0.001 |
| Chemotherapy | 1,033 | (0.3) | 358 | (34.7) | 0.49 |
| Prior venous thromboembolism | 5,553 | (1.6) | 2,445 | (44.0) | <0.001 |
| Pregnancy | 27 | (0.0) | 7 | (25.9) | 0.29 |
| Estrogens | 5,368 | (1.5) | 1,594 | (29.7) | <0.001 |
| Estrogen modulators | 2,648 | (0.8) | 818 | (30.9) | <0.001 |
| Secondary diagnosis of atrial fibrillation | 57,192 | (16.3) | 25,134 | (43.9) | <0.001 |
| Prosthetic heart valve | 3,250 | (0.9) | 1,145 | (35.2) | 0.59 |
| Congestive heart failure | 35,116 | (10.0) | 15,673 | (44.6) | <0.001 |
| Respiratory failure-secondary diagnosis | 24,760 | (7.0) | 13,144 | (53.1) | <0.001 |
| Inflammatory bowel disease | 1,149 | (0.3) | 382 | (33.2) | 0.08 |
| Nephrotic syndrome | 794 | (0.2) | 319 | (40.2) | 0.008 |
| Myeloproliferative disorder | 3,118 | (0.9) | 1,063 | (34.1) | 0.06 |
| Paroxysmal nocturnal hemoglobinuria | 9 | (0.0) | 3 | (33.3) | 0.88 |
| Obesity | 26,705 | (7.6) | 12,169 | (45.6) | <0.001 |
| Smoking | 47,139 | (13.4) | 18,150 | (38.5) | <0.001 |
| Varicose veins | 309 | (0.1) | 98 | (31.7) | 0.15 |
| Central line | 10,662 | (3.0) | 5,872 | (55.1) | <0.001 |
| Inherited or acquired thrombophilia | 295 | (0.1) | 127 | (43.1) | 0.008 |
| Diabetes mellitus | 110,717 | (31.5) | 42,407 | (38.3) | <0.001 |
| Mechanical ventilation | 18,808 | (5.4) | 12,585 | (66.9) | <0.001 |
| Computed risk of VTE | <0.001 | ||||
| <0.5% | 278,807 | (79.3) | 94,195 | (33.8) | |
| 0.5% to 1.0% | 49,587 | (14.1) | 19,221 | (38.8) | |
| >1.0% | 23,132 | (6.6) | 12,013 | (51.9) | |
| Hospital characteristics | |||||
| Region | <0.001 | ||||
| South | 193,848 | (55.1) | 68,258 | (35.2) | |
| Midwest | 66,364 | (18.9) | 25,744 | (38.8) | |
| West | 38,175 | (10.9) | 10,435 | (27.3) | |
| Northeast | 53,148 | (15.1) | 20,996 | (39.5) | |
| Number of beds | <0.001 | ||||
| 0–200 | 61,287 | (17.4) | 15,931 | (26.0) | |
| 201–300 | 57,205 | (16.3) | 17,491 | (30.6) | |
| 301–500 | 126,695 | (36.0) | 46,454 | (36.7) | |
| >500 | 106,348 | (30.3) | 45,557 | (42.8) | |
| Teaching hospital | 117,949 | (33.6) | 50,336 | (42.7) | <0.001 |
| Rural hospital | 75,058 | (21.4) | 21,174 | (28.2) | <0.001 |