Heparin Hustle: Are We Fast Enough for Intermediate-Risk PE?
Recommended Citation
Cheaito F, Channey S, Knott J, Smith ZR, To C. Heparin Hustle: Are We Fast Enough for Intermediate-Risk PE?. Am J Health Syst Pharm 2025; 82(Supplement_1):S1006.
Document Type
Conference Proceeding
Publication Date
1-8-2025
Publication Title
Am J Health Syst Pharm
Abstract
Purpose: Patients with pulmonary embolisms (PE) that have rapid attainment of therapeutic anticoagulation have improved outcomes. Severity of PE is classified as low-, intermediate-, and high-risk, and this classification determines the initial anticoagulant selected. Patients with intermediate-risk PE are eligible for catheter or surgical interventions guided by pulmonary embolism response teams (PERTs). Intravenous (IV) unfractionated heparin (UFH) is utilized in this population due to the interventional or surgical procedures they may receive. The purpose of the current study is to determine the frequency at which patients with intermediate-risk PE achieve therapeutic anticoagulation using a nursing-driven UFH protocol for venous thromboembolism (VTE). Methods: This was an IRB approved, retrospective, observational, single center study that included adult patients diagnosed with an intermediate-risk PE treated with an IV UFH protocol for VTE that were admitted to the study institution from 7/1/2020 to 6/30/24. The primary outcome was the rate of achieving a therapeutic activated partial thromboplastin time (aPTT) goal within 24 hours of IV UFH initiation. Secondary outcomes include attainment of aPTT goal at 48 hours from IV UFH initiation, PERT intervention received, ISTH major bleeding, clinical deterioration, and outpatient anticoagulation selected. Therapeutic aPTT is defined as 64 to 101 seconds. Clinical deterioration was defined as initiation of systemic thrombolytic, initiation of vasopressors, or initiation of mechanical ventilation. Descriptive statistics will be used to characterize the demographics. Categorical variables will be compared via Chi-square or Fisher's exact test, as appropriate. Continuous variables that are parametric will be compared with the student's t-test.
Volume
82
Issue
Supplement_1
First Page
S1006
