Prophylaxis of venous thromboembolism during early inpatient rehabilitation after acquired brain injury: how guidelines change management.
Saved in:
| Title: | Prophylaxis of venous thromboembolism during early inpatient rehabilitation after acquired brain injury: how guidelines change management. |
|---|---|
| Authors: | Elliott B (AUTHOR), Patel P (AUTHOR), Matharu M (AUTHOR), Amos R (AUTHOR), Machin S (AUTHOR), Liu C (AUTHOR), Greenwood R (AUTHOR) |
| Source: | Disability & Rehabilitation. Mar2006, Vol. 28 Issue 5, p333-337. 5p. |
| Abstract: | Purpose. To establish guidelines for prophylaxis of venous thromboembolism (VTE) in younger adults undergoing early inpatient rehabilitation following acquired brain injury (ABI). Method. A two-phase (phase 1: retrospective; phase 2: prospective) observational study was carried out involving patients admitted to an inpatient neurological rehabilitation unit during a 40-month period. In phase 1, VTE prophylaxis was prescribed on an ad hoc basis. In phase 2, prophylaxis was considered in accordance with guidelines agreed locally. The prescribing behaviour in each phase of the study was compared using a VTE risk stratification tool based on expert opinion and a review of the literature.Results. Data were obtained on 94 patients in phase 1 and 23 patients in phase 2. During phase 1, the prophylactic prescribing behaviour of the referring hospitals and our unit after admission were similar ( p = 0.13). In phase 2, our prescribing behaviour had changed compared with that of the referring hospitals, with a significant increase in the proportion of patients on appropriate treatment ( p = 0.01) and a decrease in the numbers undertreated ( p = 0.002). We were also significantly less likely to under-treat ( p = 0.005) and more likely to over-treat ( p = 0.004) after admission during phase 2 compared with phase 1, whilst practice was variable in patients at moderate risk. Conclusions. Guidelines modify behaviour. They must stratify risk, particularly to avoid inconsistencies in the management of patients at moderate risk. There is a need to establish national guidelines for VTE prophylaxis during early inpatient rehabilitation after ABI; these guidelines should include a risk stratification tool. [ABSTRACT FROM AUTHOR] |
| Copyright of Disability & Rehabilitation is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 106431603 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Prophylaxis of venous thromboembolism during early inpatient rehabilitation after acquired brain injury: how guidelines change management. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Elliott+B%22">Elliott B</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Patel+P%22">Patel P</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Matharu+M%22">Matharu M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Amos+R%22">Amos R</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Machin+S%22">Machin S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liu+C%22">Liu C</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Greenwood+R%22">Greenwood R</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Disability+%26+Rehabilitation%22">Disability & Rehabilitation</searchLink>. Mar2006, Vol. 28 Issue 5, p333-337. 5p. – Name: Abstract Label: Abstract Group: Ab Data: Purpose. To establish guidelines for prophylaxis of venous thromboembolism (VTE) in younger adults undergoing early inpatient rehabilitation following acquired brain injury (ABI). Method. A two-phase (phase 1: retrospective; phase 2: prospective) observational study was carried out involving patients admitted to an inpatient neurological rehabilitation unit during a 40-month period. In phase 1, VTE prophylaxis was prescribed on an ad hoc basis. In phase 2, prophylaxis was considered in accordance with guidelines agreed locally. The prescribing behaviour in each phase of the study was compared using a VTE risk stratification tool based on expert opinion and a review of the literature.Results. Data were obtained on 94 patients in phase 1 and 23 patients in phase 2. During phase 1, the prophylactic prescribing behaviour of the referring hospitals and our unit after admission were similar ( p = 0.13). In phase 2, our prescribing behaviour had changed compared with that of the referring hospitals, with a significant increase in the proportion of patients on appropriate treatment ( p = 0.01) and a decrease in the numbers undertreated ( p = 0.002). We were also significantly less likely to under-treat ( p = 0.005) and more likely to over-treat ( p = 0.004) after admission during phase 2 compared with phase 1, whilst practice was variable in patients at moderate risk. Conclusions. Guidelines modify behaviour. They must stratify risk, particularly to avoid inconsistencies in the management of patients at moderate risk. There is a need to establish national guidelines for VTE prophylaxis during early inpatient rehabilitation after ABI; these guidelines should include a risk stratification tool. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Disability & Rehabilitation is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=106431603 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/09638280500190722 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 5 StartPage: 333 Titles: – TitleFull: Prophylaxis of venous thromboembolism during early inpatient rehabilitation after acquired brain injury: how guidelines change management. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Elliott B – PersonEntity: Name: NameFull: Patel P – PersonEntity: Name: NameFull: Matharu M – PersonEntity: Name: NameFull: Amos R – PersonEntity: Name: NameFull: Machin S – PersonEntity: Name: NameFull: Liu C – PersonEntity: Name: NameFull: Greenwood R IsPartOfRelationships: – BibEntity: Dates: – D: 15 M: 03 Text: Mar2006 Type: published Y: 2006 Identifiers: – Type: issn-print Value: 09638288 Numbering: – Type: volume Value: 28 – Type: issue Value: 5 Titles: – TitleFull: Disability & Rehabilitation Type: main |
| ResultId | 1 |
