Pulmonary vascular disease & thromboembolism
Universal Electronic Health Records (EHRs) Clinical Decision Support for Thromboprophylaxis in Medical Inpatients: A Cluster Randomized Trial
Authors' conclusion
EHR-embedded CDS increased appropriate thromboprophylaxis and reduced thromboembolism without increasing major bleeding in medically ill inpatients. Mortality was higher at intervention hospitals.
Study context
- Population
- Inpatients over age 60 with key medical illnesses10,699 analysed
- Participants
- 19,823 participants
- Comparison
- EHR-integrated clinical decision support (CDS) vs usual care
- Primary endpoint
- Rate of appropriate thromboprophylaxis
Methodological details4 tertiary academic hospitals, December 21, 2020 to January 21, 2022
- 4 tertiary academic hospitals
- December 21, 2020 to January 21, 2022
Primary result
As reported in the abstract
Appropriate thromboprophylaxis
Intervention
- Inpatient
- 80.1%
- At discharge
- 13.6%
Usual care
- Inpatient
- 72.5%
- At discharge
- 7.5%
Inpatient
Intervention80.1%
Usual care72.5%
At discharge
Intervention13.6%
Usual care7.5%
Intervention vs Usual careOdds ratio (95% CI)
Inpatient
1.52(1.39–1.67)
At discharge
1.93(1.60–2.33)
Secondary outcomes
| Outcome | Intervention | Usual care | OR (95% CI) | |
|---|---|---|---|---|
| Venous thromboembolism · through 30 days postdischarge | 2.7% | 3.3% | 0.80 (0.64–1.00) | |
| Arterial thromboembolism · through 30 days postdischarge | 0.25% | 0.70% | 0.35 (0.19–0.67) | |
| Total thromboembolism · through 30 days postdischarge | 2.9% | 4.0% | 0.71 (0.58–0.88) | |
| All-cause mortality · through 30 days postdischargeHigher at intervention hospitals | 9.1% | 7.0% | 1.32 (1.15–1.53) | |
| 0.20.5125Odds ratio (log scale) |
- Tool adoption (intervention)
- 77.8%
Safety
Major bleeding · 30 days postdischarge
- Major bleeding rare and did not differ between groups
Original publication
Universal EHRs Clinical Decision Support for Thromboprophylaxis in Medical Inpatients: A Cluster Randomized Trial. JACC Adv. Published 13 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →