![]() Supply billing codes were used to determine CVC placement and the use of mechanical prophylaxis. In addition, admissions with a length of stay of ≤2 days were excluded because a full assessment of VTE risk may not occur until 24 hours after hospital admission or may not be considered in patients known to be admitted solely for overnight observation. In an effort to focus on anticoagulant use for prophylaxis, patients with a VTE diagnosis at any time during the study period were excluded. Unfractionated heparin as a TP was not investigated because we could not delineate whether heparin was used for TP or as a line flush. Prospective cohort studies are needed to determine VTE risk factors in adolescents and children with SCD and the efficacy and safety of prophylactic regimens.Īnticoagulant medications (enoxaparin, fondaparinux, apixaban, rivaroxaban, and dabigatran) were identified by pharmacy billing codes. This study demonstrates a steady increase in TP use in adolescent patients with SCD admitted to the hospital. The use of prophylactic direct oral anticoagulants was first documented in 2018 and increased to 25% of admissions with pharmacologic TP by 2021. Enoxaparin was the most commonly prescribed anticoagulant, used in 87% of admissions in which pharmacologic TP was used. Pharmacologic TP increased in use from 1.3% of admissions in 2010 to 14.4% in the first half of 2021. Pharmacologic or mechanical TP was used in 2600 (7.6%) admissions, with 3.6% of admissions (n = 1225) receiving pharmacologic prophylaxis and 4.3% (n = 1474) receiving mechanical prophylaxis. A total of 7202 unique patients consisting of 34 094 unique admissions were included for analyses. ![]() The study included patients with SCD aged 13 to 21 years, admitted to a PHIS hospital between 1 January, 2010, and 30 June, 2021. We hypothesized that TP was increasingly used in hospitalized adolescent patients with SCD. This study aimed to assess the use of pharmacologic and nonpharmacologic TP in adolescent patients with SCD using the Pediatric Health Information System (PHIS). Despite the increased risk of venous thromboembolism in the SCD population, there is limited evidence available to guide thromboprophylaxis (TP) practices in these patients. Patients with sickle cell disease (SCD) are predisposed to a hypercoagulable state. ![]()
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