Do hospital doctors test for thrombophilia in patients with venous thromboembolism?

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Serval ID
serval:BIB_66F79DCDACD6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Do hospital doctors test for thrombophilia in patients with venous thromboembolism?
Journal
Journal of thrombosis and thrombolysis
Author(s)
Samim D., Marques-Vidal P., Alberio L., Waeber G., Méan M.
ISSN
1573-742X (Electronic)
ISSN-L
0929-5305
Publication state
Published
Issued date
08/2018
Peer-reviewed
Oui
Volume
46
Number
2
Pages
238-243
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The predictive value of factor V Leiden and the G20210A prothrombin mutation regarding recurrent venous thromboembolism (VTE) is limited and does not influence subsequent patient management. Systematic testing for such genetic thrombophilia should be avoided, but to which extent such testing is practiced in a Swiss Hospital is unknown. To examine the current practice of factor V Leiden and/or G20210A prothrombin mutation testing in a University Hospital, and to assess the clinical consequences of testing on patients. 1388 adult patients (48.7% women) with a main diagnosis of VTE hospitalized at the Lausanne university hospital between January 2013 and December 2015. FV Leiden and/or prothrombin G20210A mutation testing was performed in 61 (4.4%) patients with VTE, an average of 20 patients/year. On multivariable analysis, age < 65 years [odds ratio and (95% confidence interval) 5.91 (3.12-11.19)], being admitted in a medical ward [5.71 (2.02-16.16)] and staying in the intensive care unit [0.34 (0.12-0.97)] were associated with thrombophilia testing. No differences were found between patients with and without testing regarding in-hospital mortality [OR and 95% CI for tested vs. non-tested: 0.23 (0.03-1.73), p = 0.153] and length of stay (multivariable adjusted average ± standard error: 16.9 ± 3.3 vs. 20.0 ± 0.7 days for tested and non-tested patients, respectively, p = 0.875). Thrombophilia testing in hospitalized patients with a main diagnosis of VTE is seldom performed. FV Leiden and/or prothrombin G20210A mutation should not be routinely assessed in patients with acute VTE.
Keywords
Adult, Factor V, Genetic Predisposition to Disease, Genetic Testing, Hospital Mortality, Hospitals, Humans, Length of Stay, Middle Aged, Mutation, Practice Patterns, Physicians', Prothrombin/genetics, Thrombophilia/diagnosis, Venous Thromboembolism/genetics, Hospital data, In-hospital mortality, Length of stay, Thrombophilia testing, Venous thromboembolism
Pubmed
Web of science
Create date
27/06/2018 15:30
Last modification date
20/08/2019 14:22
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