Key Points
- Determine the prescription rates of pharmacologic thromboprophylaxis and identify clinical factors influencing its administration in hospitalized patients with cancer.
- Prospective, cross-sectional multicenter study conducted across five academic medical centers evaluating hospitalized patients with cancer (N=775).
- Assessed prescription patterns, relative contraindications to anticoagulation, and venous thromboembolism risk categorized by the Padua Scoring System.
- Relative contraindications to anticoagulation were present in 31.9% of patients (247/775); among eligible patients without contraindications, 74.2% received pharmacologic thromboprophylaxis (95% CI, 70.4% to 78.0%; 392 of 528).
- Prophylaxis was significantly more common in nonhematologic versus hematologic malignancies (OR, 2.34; 95% CI, 1.43 to 3.82; P=.007) and less common for admissions specifically for cancer therapy (OR, 0.37; 95% CI, 0.22 to 0.61; P<.001).
- Prescription was poorly aligned with risk: 63% of low-risk patients received prophylaxis, while 58.8% of the 136 untreated patients without contraindications were high risk by the Padua score.
Structured PICO
PPopulation775 hospitalized patients with cancer at five academic medical centers
IInterventionPharmacologic thromboprophylaxis
OOutcomePrescription rates of thromboprophylaxis and factors influencing its use during hospitalization
Pharmacologic thromboprophylaxis is frequently prescribed to hospitalized cancer patients but is poorly targeted, with high rates of use in low-risk patients and underuse in high-risk patients.