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Summary: Hospital‐associated venous thromboembolism (VTE) is defined as any case of VTE occurring during hospital admission and for up to 90 days post discharge. It accounts for over 50% of all cases of VTE internationally; indeed, there are an estimated 10 million cases of hospital‐associated VTE annually. Over the last decade, there has been increasing interest in improving VTE risk assessment and thromboprophylaxis. This review summarises all the recent and ongoing major research studies and future challenges in the different areas, including medical, surgical and obstetric patients, as well as special areas such as lower limb immobilisation. We include sections on both pharmacological and mechanical thromboprophylaxis. [ABSTRACT FROM AUTHOR]

SUMMARY: A national Venous Thromboembolism (VTE) Prevention Programme was introduced in England in 2010, with limited subsequent study of its impact. Whilst the National Outcomes Framework reports VTE deaths related to hospitalisation annually, there are little data regarding VTE prevention practice or non‐fatal VTE associated with hospitalisation. We report the first national thrombosis survey undertaken in collaboration with Getting It Right First Time. 98 Trusts (103 sites, 67% of 144 invited) participated in at least one survey, contributing data regarding VTE prevention in 9553 patients. Anti‐coagulant thromboprophylaxis was prescribed to 88% (when indicated), with 8.1% of patients missing doses. Written patient information was provided to 31%. Of 4595 episodes of hospital‐associated VTE, 13% were considered potentially preventable. The survey highlights the success of the national programme and areas for improvement in delivery of thromboprophylaxis and patient information. [ABSTRACT FROM AUTHOR]

Summary: The level of venous thrombosis risk in women who experience spontaneous or induced pregnancy loss has previously been uncertain. However, recent data indicate that the risk of venous thrombosis in women undergoing pregnancy termination in the first trimester is increased two‐fold compared to non‐pregnant women but reduced five‐fold compared to women in the 6 weeks following a term birth. The termination procedure itself appears not to influence thrombosis risk. In light of this data, this consensus statement provides recommendations for reducing the risk of venous thrombosis in women undergoing spontaneous or induced pregnancy loss based on Royal College of Obstetricians and Gynaecologists risk stratification guidelines. [ABSTRACT FROM AUTHOR]

The article discusses a study on the role of metalloproteinase with a Thrombospondin type 1 motif, member 13 (ADAMTS13) activity in the diagnosis and exclusion of thrombotic thrombocytopenic purpura (TTP). Topics include importance of early treatment of TTP, characteristics of TTP patients and non-TTP patients in the study, and complications of plasma infusion.

This study aimed to estimate the diagnostic utility of biomarkers for suspected venous thromboembolism (VTE) in pregnancy and the puerperium. Research nurses/midwives collected blood samples from 310 pregnant/postpartum women with suspected pulmonary emboli (PE) and 18 with diagnosed deep vein thrombosis (DVT). VTE was diagnosed using imaging, treatment and adverse outcome data. Primary analysis was limited to women with conclusive imaging (36 with VTE, 247 without). The area under the curve (AUC) for each biomarker was: activated partial thromboplastin time 0.669 (95% confidence interval 0.570-0.768), B-type natriuretic peptide 0.549 (0.453-0.645), C-reactive protein 0.542 (0.445-0.639), Clauss fibrinogen 0.589 (0.476-0.701), D-Dimer (by enzyme-linked immunosorbent assay) 0.668 (0.561-0.776), near-patient D-Dimer 0.651 (0.545-0.758), mid-regional pro-atrial natriuretic peptide 0.524 (0.418-0.630), prothrombin fragment 1 + 2 0.562 (0.462-0.661), plasmin-antiplasmin complexes 0.639 (0.536-0.742), prothombin time 0.613 (0.508-0.718), thrombin generation lag time 0.702 (0.598-0.806), thrombin generation endogenous potential 0.559 (0.437-0.681), thrombin generation peak 0.596 (0.478-0.715), thrombin generation time to peak 0.655 (0.541-0.769), soluble tissue factor 0.531 (0.424-0.638) and serum troponin 0.597 (0.499-0.695). No diagnostically useful threshold for diagnosing or ruling out VTE was identified. In pregnancy and the puerperium, conventional and candidate biomarkers have no utility either for their negative or positive predictive value in the diagnosis of VTE. [ABSTRACT FROM AUTHOR]