Hypercoagulable workup in a community hospital setting: to test or not to test; that is the question.

Ashish Gupta, Poras Patel, Raheel Anwar, Diana Villanueva, Viswanath Vasudevan, Elizabeth Guevara
Author Information
  1. Ashish Gupta: Internal Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA.
  2. Poras Patel: Hematology-Oncology, Brooklyn Hospital Center, Brooklyn, NY, USA.
  3. Raheel Anwar: Internal Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA.
  4. Diana Villanueva: Internal Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA.
  5. Viswanath Vasudevan: Internal Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA.
  6. Elizabeth Guevara: Hematology-Oncology, Brooklyn Hospital Center, Brooklyn, NY, USA.

Abstract

: Thrombophilia tests are often ordered unnecessarily and/or inappropriately, with significant impact on healthcare costs, hospital resources, time, and potential harm to the patient. : To identify the incidence of unnecessary and inappropriate thrombophilia testing in a community hospital setting. : We retrospectively reviewed electronic medical records for patients who underwent inpatient thrombophilia testing at The Brooklyn Hospital Center from 1/1/2018 to 12/31/2018. The indications, and details of the tests, and associated costs were recorded. : A total of 62 patients were included (mean age 45.8, 67.7% female). In 57/62 (91.9%) patients, tests were ordered in the acute phase of thrombosis. At the time the tests were ordered, 29/62 (46.8%) patients were on anticoagulation. Positive results were found in 21/62 (53.2%) patients, but was repeated in only 1/21 (4.7%) patient. Results for 51/62 (82%) patients were obtained after discharge. The hematology-oncology service was consulted in 5/62 (8.1%) cases and recommended testing in only 1 (1.6%) patient. Only 1 (1.6%) patient had both an appropriate indication and appropriate testing. Costs for the 273 total tests were $26,400. : Thrombophilia tests were often ordered inappropriately and unnecessarily. We recommend testing only for patients with inpatient status under recommendation from the hematology-oncology service.

Keywords

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Word Cloud

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