Session: 901. Health Services Research—Non-Malignant Conditions: Poster I
Hematology Disease Topics & Pathways:
Diseases, Bleeding and Clotting, Pediatric, Young Adult, Study Population, Clinically relevant, Quality Improvement
Methods: This is a secondary use of existing clinical care data study, involving review of the patients receiving a consult from the inpatient coagulation consult service. Average daily census was documented via a clinical tracking system. Data collection ranged from May 2011 to May 2020. Since 2013, number of distinct new consults (not repeat patients), and indication for consult have also been documented. These data were analyzed for trends in average census number and indication for consult. Additionally, the service requesting the consult is also reported.
Results: From May 2011 to May 2020, the average daily census for the coagulation consult service has increased from 4.5 to 34.4 patients. (Figure 1) The rate of consult request for prophylactic anticoagulation increased from 8 in 2013 to 82 in 2020, while thrombosis and bleeding referrals remained relatively stable. (Figure 2) Since 2013, the service with the most requests for prophylactic anticoagulation over the entire period was orthopedic surgery with 70, followed by the cardiovascular intensive care (31) and medical intensive care (28) units (ICU). There was an increase in the number of prophylactic anticoagulation consults from the ICUs over the course of the study. (Figure 3) In early 2020 a VTE risk stratification was instituted in the CVICU.
Conclusions: In this single institution, retrospective study, we noted an increase in number of consults for the coagulation service overall, and a larger increase in requests for consults for prophylactic anticoagulation. Further studies should be done to determine whether this increase in use of prophylactic anticoagulation exists at other pediatric hospitals and the impact on subsequent VTE development.
Disclosures: Carpenter: CSL Behring: Research Funding; American Thrombosis and Hemostasis Network: Membership on an entity's Board of Directors or advisory committees; Genentech, Inc.: Honoraria; Kedrion: Honoraria; Novo Nordisk: Honoraria; Shire: Research Funding; Hemostasis & Thrombosis Research Society: Membership on an entity's Board of Directors or advisory committees; American Academy of Pediatrics: Other: PREP Heme/Onc editorial board.
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