Evaluation of thrombophilia testing in the inpatient setting: A single institution retrospective review
Document Type
Article
Publication Date
1-1-2021
Publication Title
PloS one
E-ISSN
1932-6203
Department(s)
Department of Medicine; Hematology-Medical Oncology Division; Fellows and Residents
Abstract
BACKGROUND: Thrombophilia workup is typically inappropriate in the inpatient setting as testing may be skewed by anticoagulation, acute thrombosis, or acute illness. OBJECTIVE: To determine adherence of inpatient thrombophilia testing with institutional guidelines. PATIENTS AND METHODS: A retrospective study to evaluate thrombophilia testing practices of adult patients who were admitted to Lehigh Valley Hospital at Cedar Crest with either venous thromboembolism or ischemic stroke in 2019. Testing included inherited and acquired thrombophilia. Patient charts were individually reviewed for three measured outcomes: 1) the number of appropriate thrombophilia testing in the inpatient setting; 2) the indications used for thrombophilia testing; 3) the proportion of positive thrombophilia tests with change in clinical management. RESULTS: 201 patients were included in our study. 26 patients (13%) were tested appropriately in accordance with institution guidelines and 175 (87%) patients were tested inappropriately. The most common reason for the inappropriate testing was testing during acute thrombosis. 28 of the 201 patients had positive thrombophilia tests, but the reviewers only noted 7 patients with change in clinical management-involving anticoagulation change. CONCLUSION: Our study revealed that a majority of inpatient thrombophilia testing did not follow institutional guidelines for appropriate testing and did not change patient management. These thrombophilia tests are often overutilized and have minimal clinical utility in the inpatient setting.
Volume
16
Issue
9
First Page
e0257687
DOI
10.1371/journal.pone.0257687
PubMed ID
34543355
Recommended Citation
Siu, C., Wolfe, Z., DelaTorre, M., Rehim, E., Decker, R. V., Zaffiri, K., & Lash, B. (2021). Evaluation of thrombophilia testing in the inpatient setting: A single institution retrospective review. LVHN Scholarly Works. Retrieved from https://scholarlyworks.lvhn.org/research-historical-works/35
DOI: 10.1371/journal.pone.0257687