An Evaluation of Outcomes Related to the Use of a VTE Prophylaxis Assessment Tool in Obstetrical Patients at Northwest Medical Center

Abstract

Specific Aims: To evaluate the relationship between standardized venous thromboembolism (VTE) risk assessment, subsequent use of pharmacologic prophylaxis and outcomes related to VTE and bleeding. Subjects: Pregnant women who were admitted to NMC Women’s Center from January 1, 2017 to October 1, 2017 to give birth and who consented to a post-discharge phone call. Methods: An in-house risk assessment instrument was used to measure an individual’s risk of VTE on admission and post-delivery. Six weeks post-discharge, consented eligible patients were contacted via phone to determine VTE occurrence outpatient or inpatient, VTE prophylaxis occurrence, and experienced outpatient adverse drug events (ADE). All data were recorded in a data collection spreadsheet and analyzed. Main Results: A total of 707 women were included in the study. Most patients had a total risk score of zero (antepartum [AP]: 74.4%, postpartum [PP]: 51.9%). Seventeen (2.4%) AP patients and 72 (12.8%) PP patients scored high risk (defined as total score ≥ 4). Of the 17 high risk AP patients, 8 received postpartum prophylaxis. Of the 72 high risk PP patients, 13 received postpartum prophylaxis. There were no reported ADEs associated with any prophylactic drug therapy. One patient experienced a deep vein thrombosis incident in the six weeks postpartum period and zero in the antepartum period. Conclusions: Among the participants who received a VTE risk assessment pre- and postpartum, one participant experienced a VTE during the six week postpartum window. Additionally, there was no notable difference in ADEs in patients receiving pharmacological prophylaxis despite increased use.