Inpatient thrombophilia workup; does hematology consult prevent unnecessary testing?

Area of Science:

• Hematology
• Internal Medicine

Background:

• Hypercoagulable disorders increase the risk of thrombi in veins or arteries.
• Inpatient thrombophilia workups are common for unprovoked venous thromboembolism to find underlying causes.

Purpose of the Study:

• To evaluate the appropriateness and impact of inpatient thrombophilia testing.
• To assess adherence to American Society of Hematology guidelines regarding thrombophilia workups.

Main Methods:

• Retrospective chart review of patients with unprovoked venous thromboembolism.
• Analysis of thrombophilia testing appropriateness based on established criteria.
• Correlation of testing with diagnosis, anticoagulation, and consultations.

Main Results:

• Only 15% of patients met criteria for appropriate thrombophilia testing.
• Appropriate testing did not correlate with thrombophilia diagnosis or anticoagulation initiation.
• Appropriate testing was associated with Hematology-Oncology consultation.

Conclusions:

• Inpatient thrombophilia testing is frequently overutilized and rarely influences patient management.
• Expert consultation may be beneficial when considering thrombophilia testing.
• Strong recommendations against routine inpatient testing are warranted to conserve healthcare resources.