CROATIAN EXPERIENCE OF THROMBOPHILIA TESTING ? A HUGE VARIETY OF REFERRING PRIMARY PHYSICIANS, DIFFERENT INDICATIONS, AND PATIENTS? CHARACTERISTICS
(Abstract release date: 05/19/16)
EHA Library. Pulanic D. 06/09/16; 135108; PB2208
Dr. Drazen Pulanic
Contributions
Contributions
Abstract
Abstract: PB2208
Type: Publication Only
Background
Thrombophilia is a predisposition to thrombosis and is not disease per se, but exposes carriers to increased risks for thrombosis compared with non-carriers. Some earlier studies showed also association between thrombophilia and adverse pregnancy outcomes. However, it is still a matter of intense debate who should undergo comprehensive and expensive laboratory testing for thrombophilia and its usefulness in clinical practice.
Aims
The aim of this work was to analyze indications, patients’ characteristics and specializations of referring primary physicians who requested thrombophilia testing with hematology consultation.
Methods
We analyzed patients referred for thrombophilia testing with hematology consultation to the Coagulation Outpatient Unit of the Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia, from 2013-2014. Study was approved by the Medical ethic committee.
Results
There were 351 new patients sent from different specialists for thrombophilia work-up, median age 38 years (range 18-82 years), and among them majority were female patients (68.1%). The most frequent specialists who requested testing of the patients were gynecologists (30.2%), followed by internal medicine specialists with different subspecialisations (20.5%), cardiologists (11.96%), hematologists from other institutions (9.4%), family physicians (9.1%), neurologists (7.7%), vascular surgeons (5.1%), ophthalmologists (1.7%), and others. The most common indication for thrombophilia testing was personal history of venous thromboembolism (VTE) (deep vein thrombosis, pulmonary embolism or both) in 50.9% of analyzed patients. Among patients who had VTE, 64.4% had idiopathic VTE and 18.9% had recurrent VTE. The most common causes of secondary VTE were trauma, surgery and immobilization (34.3% of secondary VTE). The second most common indication for thrombophilia testing were gynecology/obstetric reasons (recurrent or even the first time miscarriages, pregnancy complications (intrauterine fetal growth restriction, preeclampsia, abruption placentae), and sterility) among 28.5% of all patients (41.8% of female patients). Other indications for request for thrombophilia testing with hematology consultation were stroke (5.7%), varicose veins (5.4%), recurrent thrombophlebitis (5.1%), myocardial infarction (1.9%), retinal vein thrombosis (1.7%), and other. More than 1 reason for testing had 14.5% of patients, and 25.15% of patients had positive family history for VTE. In addition to request for laboratory hypercoagulable work-up, 27.9% of the patients confirmed that were active smokers.
Conclusion
Although in general majority of patients sent for thrombophilia testing with hematology consultation were younger people with previously unprovoked VTE, there was huge variety of indications and different kind of specializations of primary physicians who requested testing. Gynecologists as referring physicians and gynecology/obstetric reasons were especially frequent, what might change in the following years with new data about clinical indications and usefulness of thrombophilia testing.
Session topic: E-poster
Keyword(s): Inherited thrombophilia, Thrombophilia, Thrombosis, Venous thromboembolism
Type: Publication Only
Background
Thrombophilia is a predisposition to thrombosis and is not disease per se, but exposes carriers to increased risks for thrombosis compared with non-carriers. Some earlier studies showed also association between thrombophilia and adverse pregnancy outcomes. However, it is still a matter of intense debate who should undergo comprehensive and expensive laboratory testing for thrombophilia and its usefulness in clinical practice.
Aims
The aim of this work was to analyze indications, patients’ characteristics and specializations of referring primary physicians who requested thrombophilia testing with hematology consultation.
Methods
We analyzed patients referred for thrombophilia testing with hematology consultation to the Coagulation Outpatient Unit of the Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia, from 2013-2014. Study was approved by the Medical ethic committee.
Results
There were 351 new patients sent from different specialists for thrombophilia work-up, median age 38 years (range 18-82 years), and among them majority were female patients (68.1%). The most frequent specialists who requested testing of the patients were gynecologists (30.2%), followed by internal medicine specialists with different subspecialisations (20.5%), cardiologists (11.96%), hematologists from other institutions (9.4%), family physicians (9.1%), neurologists (7.7%), vascular surgeons (5.1%), ophthalmologists (1.7%), and others. The most common indication for thrombophilia testing was personal history of venous thromboembolism (VTE) (deep vein thrombosis, pulmonary embolism or both) in 50.9% of analyzed patients. Among patients who had VTE, 64.4% had idiopathic VTE and 18.9% had recurrent VTE. The most common causes of secondary VTE were trauma, surgery and immobilization (34.3% of secondary VTE). The second most common indication for thrombophilia testing were gynecology/obstetric reasons (recurrent or even the first time miscarriages, pregnancy complications (intrauterine fetal growth restriction, preeclampsia, abruption placentae), and sterility) among 28.5% of all patients (41.8% of female patients). Other indications for request for thrombophilia testing with hematology consultation were stroke (5.7%), varicose veins (5.4%), recurrent thrombophlebitis (5.1%), myocardial infarction (1.9%), retinal vein thrombosis (1.7%), and other. More than 1 reason for testing had 14.5% of patients, and 25.15% of patients had positive family history for VTE. In addition to request for laboratory hypercoagulable work-up, 27.9% of the patients confirmed that were active smokers.
Conclusion
Although in general majority of patients sent for thrombophilia testing with hematology consultation were younger people with previously unprovoked VTE, there was huge variety of indications and different kind of specializations of primary physicians who requested testing. Gynecologists as referring physicians and gynecology/obstetric reasons were especially frequent, what might change in the following years with new data about clinical indications and usefulness of thrombophilia testing.
Session topic: E-poster
Keyword(s): Inherited thrombophilia, Thrombophilia, Thrombosis, Venous thromboembolism
Abstract: PB2208
Type: Publication Only
Background
Thrombophilia is a predisposition to thrombosis and is not disease per se, but exposes carriers to increased risks for thrombosis compared with non-carriers. Some earlier studies showed also association between thrombophilia and adverse pregnancy outcomes. However, it is still a matter of intense debate who should undergo comprehensive and expensive laboratory testing for thrombophilia and its usefulness in clinical practice.
Aims
The aim of this work was to analyze indications, patients’ characteristics and specializations of referring primary physicians who requested thrombophilia testing with hematology consultation.
Methods
We analyzed patients referred for thrombophilia testing with hematology consultation to the Coagulation Outpatient Unit of the Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia, from 2013-2014. Study was approved by the Medical ethic committee.
Results
There were 351 new patients sent from different specialists for thrombophilia work-up, median age 38 years (range 18-82 years), and among them majority were female patients (68.1%). The most frequent specialists who requested testing of the patients were gynecologists (30.2%), followed by internal medicine specialists with different subspecialisations (20.5%), cardiologists (11.96%), hematologists from other institutions (9.4%), family physicians (9.1%), neurologists (7.7%), vascular surgeons (5.1%), ophthalmologists (1.7%), and others. The most common indication for thrombophilia testing was personal history of venous thromboembolism (VTE) (deep vein thrombosis, pulmonary embolism or both) in 50.9% of analyzed patients. Among patients who had VTE, 64.4% had idiopathic VTE and 18.9% had recurrent VTE. The most common causes of secondary VTE were trauma, surgery and immobilization (34.3% of secondary VTE). The second most common indication for thrombophilia testing were gynecology/obstetric reasons (recurrent or even the first time miscarriages, pregnancy complications (intrauterine fetal growth restriction, preeclampsia, abruption placentae), and sterility) among 28.5% of all patients (41.8% of female patients). Other indications for request for thrombophilia testing with hematology consultation were stroke (5.7%), varicose veins (5.4%), recurrent thrombophlebitis (5.1%), myocardial infarction (1.9%), retinal vein thrombosis (1.7%), and other. More than 1 reason for testing had 14.5% of patients, and 25.15% of patients had positive family history for VTE. In addition to request for laboratory hypercoagulable work-up, 27.9% of the patients confirmed that were active smokers.
Conclusion
Although in general majority of patients sent for thrombophilia testing with hematology consultation were younger people with previously unprovoked VTE, there was huge variety of indications and different kind of specializations of primary physicians who requested testing. Gynecologists as referring physicians and gynecology/obstetric reasons were especially frequent, what might change in the following years with new data about clinical indications and usefulness of thrombophilia testing.
Session topic: E-poster
Keyword(s): Inherited thrombophilia, Thrombophilia, Thrombosis, Venous thromboembolism
Type: Publication Only
Background
Thrombophilia is a predisposition to thrombosis and is not disease per se, but exposes carriers to increased risks for thrombosis compared with non-carriers. Some earlier studies showed also association between thrombophilia and adverse pregnancy outcomes. However, it is still a matter of intense debate who should undergo comprehensive and expensive laboratory testing for thrombophilia and its usefulness in clinical practice.
Aims
The aim of this work was to analyze indications, patients’ characteristics and specializations of referring primary physicians who requested thrombophilia testing with hematology consultation.
Methods
We analyzed patients referred for thrombophilia testing with hematology consultation to the Coagulation Outpatient Unit of the Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia, from 2013-2014. Study was approved by the Medical ethic committee.
Results
There were 351 new patients sent from different specialists for thrombophilia work-up, median age 38 years (range 18-82 years), and among them majority were female patients (68.1%). The most frequent specialists who requested testing of the patients were gynecologists (30.2%), followed by internal medicine specialists with different subspecialisations (20.5%), cardiologists (11.96%), hematologists from other institutions (9.4%), family physicians (9.1%), neurologists (7.7%), vascular surgeons (5.1%), ophthalmologists (1.7%), and others. The most common indication for thrombophilia testing was personal history of venous thromboembolism (VTE) (deep vein thrombosis, pulmonary embolism or both) in 50.9% of analyzed patients. Among patients who had VTE, 64.4% had idiopathic VTE and 18.9% had recurrent VTE. The most common causes of secondary VTE were trauma, surgery and immobilization (34.3% of secondary VTE). The second most common indication for thrombophilia testing were gynecology/obstetric reasons (recurrent or even the first time miscarriages, pregnancy complications (intrauterine fetal growth restriction, preeclampsia, abruption placentae), and sterility) among 28.5% of all patients (41.8% of female patients). Other indications for request for thrombophilia testing with hematology consultation were stroke (5.7%), varicose veins (5.4%), recurrent thrombophlebitis (5.1%), myocardial infarction (1.9%), retinal vein thrombosis (1.7%), and other. More than 1 reason for testing had 14.5% of patients, and 25.15% of patients had positive family history for VTE. In addition to request for laboratory hypercoagulable work-up, 27.9% of the patients confirmed that were active smokers.
Conclusion
Although in general majority of patients sent for thrombophilia testing with hematology consultation were younger people with previously unprovoked VTE, there was huge variety of indications and different kind of specializations of primary physicians who requested testing. Gynecologists as referring physicians and gynecology/obstetric reasons were especially frequent, what might change in the following years with new data about clinical indications and usefulness of thrombophilia testing.
Session topic: E-poster
Keyword(s): Inherited thrombophilia, Thrombophilia, Thrombosis, Venous thromboembolism
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