Category Archives: Hematology and Oncology

VTE rates not a good indicator of care quality

This large analysis of US hospitals found those with higher VTE prophylaxis rates were associated with higher VTE rates, and hospitals with higher VTE surveillance testing had higher VTE rates. Publicly reported VTE rates may be more reflective of VTE … Continue reading

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Edoxaban non-inferior to warfarin for acute VTE

This large trial randomized patients with acute VTE to oral edoxaban (factor Xa inhibitor) or warfarin for 3-12 months; edoxaban was non-inferior to warfarin for recurrent symptomatic VTE, but had fewer bleeding episodes (abstract).

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Dabigatran not safe or effective with heart valves

This trial of patients with mechanical aortic or mitral heart valves randomized them to dabigatran or warfarin and found dabigatran was associated with higher risks of both thromboembolic and bleeding events (abstract).

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New oral anticoagulants for VTE prophylaxis after TKA/THA

This meta analysis found the new oral anticoagulants had similar VTE outcomes compared to LMWH, but the risk of bleeding is higher, in patients status post TKA/THA (abstract).

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IV iron reduces transfusions, but increases infections

This systematic review found IV iron infusions increased hemoglobin and reduced the need for blood transfusions, but increased the risk of infections (relative risk 1.3, CI 1.1 to 1.6) (abstract).

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Warfarin reversal with FFP versus prothrombin complex

This retrospective analysis evaluated time to reversal and adverse events in patients on warfarin with an INR >1.5, treated with FFP or prothrombin complex. FFP was associated with longer time to reversal (11.8 versus 5.7 hours) and twice the rate … Continue reading

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Hospital acquired anemia

This multicenter study found that ~3/4 of hospital admissions developed hospital acquired anemia (about 1/3 each were mild, moderate, and severe). Worsening anemia was associated with higher in-hospital mortality and resource utilization (abstract).

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Once daily LMWH for acute VTE

The Cochrane review found no differences in outcomes between once versus twice daily LMWH in patients with acute VTE, and once daily is more convenient and cost effective (abstract).

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Apixaban for acute VTE treatment

This large multicenter trial randomized patients with acute VTE to apixaban (10mg BID for 1 week, followed by 5mg BID for 6 months) versus conventional therapy (lovenox-warfarin). The primary outcome was similar between groups (symptomatic VTE or death related to … Continue reading

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Subsegmental PE same outcome as proximal PE

This study assessed the characteristics and outcomes of patients with subsegmental and proximal PEs, and found they were similar, including cumulative death rates of 10% and 6%, respectively. Subsegmental PEs carry the same risks as proximal PEs and should be … Continue reading

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