CINECA IRIS Institutional Research Information System
IRIS è la soluzione IT che facilita la raccolta e la gestione dei dati relativi alle attività e ai prodotti della ricerca. Fornisce a ricercatori, amministratori e valutatori gli strumenti per monitorare i risultati della ricerca, aumentarne la visibilità e allocare in modo efficace le risorse disponibili.
EnglishAim: To investigate the prevalence and clinical correlates of overprescribing and underprescribing of low molecular weight heparins (LMWHs) for thromboprophylaxis among older medical inpatients. Methods: Eight hundred seventy six patients (mean age 81.5 ± 7.6 years, female gender 57.2 %) enrolled in a multicenter observational study of seven acute care wards of geriatric medicine in Italy. The risk of venous thromboembolism was ascertained by calculating the Padua score for each patient. Patients receiving appropriate prescription of LMHW during stay were compared to those receiving LMHW with a Padua score <4 (overprescribing group). Similarly, patients with a high thromboembolic risk (Padua score ≥4) but not receiving LMHW (underprescribing group) were compared to patients appropriately not receiving LMHW during stay. Independent correlates of overprescribing and underprescribing were investigated by logistic regression analysis. Results: Overall, 42.8 % of patients had a Padua score ≥4. LMWHs were overprescribed in 7.3 % and underprescribed in 25.2 % of patients. The number of lost basic activities of daily living (BADL) (OR = 0.25; 95 % CI 0.15–0.41) and the number of diagnoses (OR = 0.76; 95 % CI 0.61–0.95) were inversely associated with LMWH overprescription. Conversely, older age (75–84 years: OR = 2.39; 95 % CI 1.10–5.19—85 years or more: OR = 3.25, 95 % CI 1.40–7.61), anemia (OR = 1.80, 95 % CI 1.05–3.16), pressure sores (OR = 4.15, 95 % CI 1.20–14.3), number of lost BADL at the admission (OR = 3.92, 95 % CI 2.86–5.37) and number of diagnoses (OR = 1.29, 95 % CI 1.15–1.44) qualified as significant correlates of LMWH underprescription. Discussion: Underprescription and, to a lesser extent, overprescription still represent an issue among older medical inpatients. Conclusion: Implementing risk-stratifying scores into clinical practice may improve appropriateness of LMWHs prescribing during hospitalization.
Scheda prodotto non validato
Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo
| Data di pubblicazione: | 2017 | |
| Titolo: | Inappropriate prescription of low molecular weight heparins for thromboprophylaxis among older hospitalized patients | |
| Autori: | Garasto, Sabrina; Fusco, Sergio; Onder, Graziano; Sganga, Federica; Mammarella, Federica; Volpato, Stefano; Ruggiero, Carmelinda; Abbatecola, Angela M; Lattanzio, Fabrizia; Corsonello, Andrea | |
| Rivista: | AGING CLINICAL AND EXPERIMENTAL RESEARCH | |
| Parole Chiave: | Elderly; Hospital; Inappropriate prescription; Low molecular weight heparins; | |
| Abstract in inglese: | Aim: To investigate the prevalence and clinical correlates of overprescribing and underprescribing of low molecular weight heparins (LMWHs) for thromboprophylaxis among older medical inpatients. Methods: Eight hundred seventy six patients (mean age 81.5 ± 7.6 years, female gender 57.2 %) enrolled in a multicenter observational study of seven acute care wards of geriatric medicine in Italy. The risk of venous thromboembolism was ascertained by calculating the Padua score for each patient. Patients receiving appropriate prescription of LMHW during stay were compared to those receiving LMHW with a Padua score <4 (overprescribing group). Similarly, patients with a high thromboembolic risk (Padua score ≥4) but not receiving LMHW (underprescribing group) were compared to patients appropriately not receiving LMHW during stay. Independent correlates of overprescribing and underprescribing were investigated by logistic regression analysis. Results: Overall, 42.8 % of patients had a Padua score ≥4. LMWHs were overprescribed in 7.3 % and underprescribed in 25.2 % of patients. The number of lost basic activities of daily living (BADL) (OR = 0.25; 95 % CI 0.15–0.41) and the number of diagnoses (OR = 0.76; 95 % CI 0.61–0.95) were inversely associated with LMWH overprescription. Conversely, older age (75–84 years: OR = 2.39; 95 % CI 1.10–5.19—85 years or more: OR = 3.25, 95 % CI 1.40–7.61), anemia (OR = 1.80, 95 % CI 1.05–3.16), pressure sores (OR = 4.15, 95 % CI 1.20–14.3), number of lost BADL at the admission (OR = 3.92, 95 % CI 2.86–5.37) and number of diagnoses (OR = 1.29, 95 % CI 1.15–1.44) qualified as significant correlates of LMWH underprescription. Discussion: Underprescription and, to a lesser extent, overprescription still represent an issue among older medical inpatients. Conclusion: Implementing risk-stratifying scores into clinical practice may improve appropriateness of LMWHs prescribing during hospitalization. | |
| Digital Object Identifier (DOI): | 10.1007/s40520-016-0571-0 | |
| Handle: | http://hdl.handle.net/11392/2350736 | |
| Appare nelle tipologie: | 03.1 Articolo su rivista |
File in questo prodotto:
http://hdl.handle.net/11392/2350736
Copyright © 2022