Reduction in epistaxis and emergency department visits in patients taking warfarin after implementation of an education program.

Abstract:

BACKGROUND:Anticoagulated patients are often seen unnecessarily in the emergency department (ED) for epistaxis, leading to increased healthcare costs. Patients are often unaware of preventative and management techniques for handling epistaxis in the home. METHODS:In 2016, the Michigan Anticoagulation Quality Improvement Initiative (MAQI2), a Blue Cross Blue Shield of Michigan-sponsored consortium of 6 anticoagulation clinics in Michigan, implemented an epistaxis-management educational program for warfarin-treated patients with the goal of reducing unnecessary ED visits. A pre-implementation cohort (2014-2015) consisted of patients who did not receive epistaxis-related educational materials. A post-implementation cohort (2017-2018) received epistaxis educational materials covering home treatment and prevention strategies. Patient characteristics and outcomes (rates of epistaxis and epistaxis ED visits) were compared using Chi-square, Poisson regression, and t-tests. RESULTS:Of the 4473 patients included, 2634 (58.9%) initiated warfarin in the pre-implementation phase and 1839 (41.1%) initiated warfarin in the post-implementation phase. The post-implementation cohort had a lower overall epistaxis rate (13.4 vs 10.4 per 100 patient-year, pre- vs. post-implementation; p = 0.029), a lower epistaxis-related ED visit rate (5.6 vs. 3.1 per 100 patient-year; p = 0.003), and a lower proportion of nosebleeds that led to an ED visit (42% vs. 30%; p = 0.032). After controlling for antiplatelet use, renal disease, and time in therapeutic range, both cohorts were equally likely to have nosebleeds (RR 0.77, 95% CI: 0.58-1.02); however, the post-implementation cohort was less likely to visit the ED for epistaxis (RR 0.52, 95% CI: 0.32-0.84). CONCLUSION:An epistaxis education program was associated with a reduction in epistaxis-related ED visits among warfarin-treated patients.

journal_name

Thromb Res

journal_title

Thrombosis research

authors

Neshewat J,Wasserman A,Alexandris-Souphis C,Haymart B,Feldeisen D,Kong X,Harvey RS,Pynnonen M,Froehlich JB,Kline-Rogers E,Barnes GD

doi

10.1016/j.thromres.2021.01.007

subject

Has Abstract

pub_date

2021-01-16 00:00:00

pages

119-122

eissn

0049-3848

issn

1879-2472

pii

S0049-3848(21)00016-5

journal_volume

199

pub_type

信件
  • No evidence for increased platelet activation in patients with hepatitis B- or C-related cirrhosis and hepatocellular carcinoma.

    abstract:INTRODUCTION:Cancer is a major risk factor for developing venous thromboembolism (VTE). Plasma hypercoagulability is an established risk factor for cancer-related VTE. In addition, thrombocytosis and hyperreactive platelets have been implicated in VTE and cancer progression. Cirrhosis is associated with changes in plat...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2014.11.016

    authors: Alkozai EM,Porte RJ,Adelmeijer J,Zanetto A,Simioni P,Senzolo M,Lisman T

    更新日期:2015-02-01 00:00:00

  • Granulocyte colony-stimulating factor decreases the Th1/Th2 ratio in peripheral blood mononuclear cells from patients with chronic immune thrombocytopenic purpura in vitro.

    abstract::Chronic immune thrombocytopenia purpura (ITP) is an autoimmune disease that exhibits an abnormally high Th1/Th2 ratio. Granulocyte colony-stimulating factor (G-CSF) has been shown to decrease the Th1/Th2 ratio in healthy donors. In this study, we investigated the effects of G-CSF treatment on the Th1/Th2 cells and the...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2016.10.028

    authors: Ge F,Zhang Z,Hou J,Cao F,Zhang Y,Wang P,Wei H,Zhou J

    更新日期:2016-12-01 00:00:00

  • Effects of exercise test on plasma markers of an activation of coagulation and/or fibrinolysis in patients with symptomatic or silent myocardial ischemia.

    abstract::It has been suggested that unstable angina at rest, like acute myocardial infarction, might be associated with a thrombotic process. In order to study the hypothesis that myocardial ischemia during exercise could also be associated with an activation of blood coagulation and/or fibrinolysis, we investigated the presen...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(92)90222-v

    authors: Bounameaux H,Righetti A,de Moerloose P,Bongard O,Reber G

    更新日期:1992-01-01 00:00:00

  • Urinary procoagulant behaves as tissue factor by promoting factor VIIa-catalyzed activation of factor X.

    abstract::We purified the urinary procoagulant from frozen human urine by introducing phenyl-Sepharose hydrophobic chromatography. By this method, the apoprotein of the procoagulant and the lipid-like substance were separately recovered. Upon reassociation with the lipid-like substance or exogenous crude phospholipids, the apop...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(84)90114-2

    authors: Kurosawa S,Matsuda M,Aoki N

    更新日期:1984-03-15 00:00:00

  • Influence of exogenous and endogenous tissue-type plasminogen activator on the lysability of clots in a plasma milieu in vitro.

    abstract::The fibrinolytic potential of tissue-type plasminogen activator (t-PA) either incorporated in a clot (endogenous) or added to the surrounding plasma (exogenous), was studied in an in vitro system consisting of 125I-labeled human plasma clots (200 microliters) immersed in human plasma (2 ml). Clot lysis was measured as...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(84)90364-5

    authors: Zamarron C,Lijnen HR,Collen D

    更新日期:1984-08-01 00:00:00

  • Joint disease, the hallmark of haemophilia: what issues and challenges remain despite the development of effective therapies?

    abstract::Although effective therapies for haemophilia have been available for decades, the prevention and treatment of joint disease remain major clinical concerns for all haemophilia patients. Early identification of joint disease is vital to initiate or modify treatment, and prevent arthropathy. However, there remains a need...

    journal_title:Thrombosis research

    pub_type: 杂志文章,评审

    doi:10.1016/j.thromres.2014.02.015

    authors: Lambert T,Auerswald G,Benson G,Hedner U,Jiménez-Yuste V,Ljung R,Morfini M,Remor E,Santagostino E,Zupančić Šalek S

    更新日期:2014-06-01 00:00:00

  • Construction and its expression of a new retroviral vector containing a human blood coagulation factor IX cDNA.

    abstract::We constructed a new factor IX expression vector containing a full length factor IX cDNA. The Moloney Murine Leukemia Virus (MoMLV)-based retroviral vector pLRNL was cloned with the entire coding region of human factor IX down stream of the promoter of Rous sarcoma virus, giving rise to the construct pL9RNL. The GP+E ...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(93)90038-p

    authors: Matsushita T,Emi N,Takahashi I,Takamatsu J,Saito H

    更新日期:1993-02-15 00:00:00

  • Effects of different aspirin formulations on platelet aggregation times and on plasma salicylate concentrations.

    abstract:BACKGROUND:Early aspirin treatment is widely used to inhibit platelet activity and to reduce morbidity and mortality in patients presenting with an acute myocardial infarction or a stroke. A number of different aspirin formulations have been used for this purpose; however, a comparison of their effectiveness in inhibit...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2005.10.001

    authors: Schwertner HA,McGlasson D,Christopher M,Bush AC

    更新日期:2006-01-01 00:00:00

  • The thrombolytic effect of miniplasmin in a canine model of femoral artery thrombosis.

    abstract:BACKGROUND AND PURPOSE:Miniplasmin was a des-kringle variant of plasminogen with potential pharmacological application. We investigated the thrombolytic effect of miniplasmin in a canine model of femoral artery thrombosis. METHODS:In anesthetized dogs, a stable occlusive thrombus was formed by mechanical and electroly...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2008.01.007

    authors: Fu J,Ren J,Zou L,Bian G,Li R,Lu Q

    更新日期:2008-01-01 00:00:00

  • Alleviation of synovitis caused by joint instability with application of platelet-rich plasma.

    abstract:INTRODUCTION:Synovitis is an early set and persistent change during the progression of osteoarthritis, which causes symptoms such as pain and swelling of the joints. Platelet-rich plasma (PRP) can release quantities of growth factors and cytokines, and is proved effected in promoting restoration of multiple soft tissue...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2019.11.017

    authors: Yin J,Xu Z,Liu J

    更新日期:2020-02-01 00:00:00

  • Suppression of protein kinase C is associated with inhibition of PYK2 tyrosine phosphorylation and enhancement of PYK2 interaction with Src in thrombin-activated platelets.

    abstract::Blood platelets have recently been shown to express PYK2, a nonreceptor tyrosine kinase belonging to the FAK gene family. In this study, we examined the involvement of protein kinase C (PKC) in PYK2-related responses in human platelets. While PYK2 tyrosine phosphorylation induced by thrombin was inhibited by preincuba...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/s0049-3848(98)00188-1

    authors: Ohmori T,Yatomi Y,Asazuma N,Satoh K,Ozaki Y

    更新日期:1999-03-15 00:00:00

  • Properties of the complex between alpha 2-macroglobulin and brinase, a proteinase from Aspergillus oryzae with thrombolytic effect.

    abstract::The proteinase, brinase (Mr approximately 35000), from Aspergillus oryzae, which has been used in therapeutic attempts as a thrombolytic agent in arterial thrombosis, binds to purified human alpha 2-macroglobulin (alpha 2M) with a stoichiometry of 1.7-1.9 mol of enzyme/mol inhibitor. This binding leads to quantitative...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(88)90359-3

    authors: Larsson LJ,Frisch EP,Törneke K,Lindblom T,Björk I

    更新日期:1988-01-01 00:00:00

  • Measurement of dabigatran plasma concentrations by calibrated thrombin clotting time in comparison to LC-MS/MS in human volunteers on dialysis.

    abstract:INTRODUCTION:Dabigatran etexilate is an oral direct thrombin inhibitor. Although routine anticoagulation monitoring with dabigatran is not usually required, a simple and precise laboratory test to measure dabigatran concentrations in patient plasma may be useful in certain clinical circumstances, such as emergency situ...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2014.12.021

    authors: Schmohl M,Gansser D,Moschetti V,Stangier J

    更新日期:2015-03-01 00:00:00

  • Role of prophylactic filter placement in the endovascular treatment of symptomatic thrombosis in the central veins.

    abstract:OBJECTIVES:To evaluate the role of filter implantation in reducing the incidence of fatal pulmonary embolism during the endovascular treatment of thrombosis in the major tributary of the superior vena cava (SVC). METHODS:From October 2004 to October 2008, we conducted a cohort study of 40 patients with thrombosis of t...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2014.04.009

    authors: Liang Z,Han R,Qu Y,Cao W,Cui J

    更新日期:2014-07-01 00:00:00

  • Phase 1 study of human plasma-derived plasmin (TAL-05-00018) in hemodialysis graft occlusion.

    abstract:INTRODUCTION:Hemodialysis grafts often fail because of stenosis at the venous anastomosis resulting in thrombosis. Percutaneous intervention involves thrombolysis with plasminogen activators, mechanical removal of thrombus, and angioplasty of the stenotic lesions. OBJECTIVES:This article describes a phase I trial usin...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2008.06.020

    authors: Shlansky-Goldberg R

    更新日期:2008-01-01 00:00:00

  • Lower limb deep vein thrombosis in COVID-19 patients admitted to intermediate care respiratory units.

    abstract::COVID-19 has been associated with an increased risk of thrombotic events; however, the reported incidence of deep vein thrombosis varies depending, at least in part, on the severity of the disease. Aim of this prospective, multicenter, observational study was to investigate the incidence of lower limb deep vein thromb...

    journal_title:Thrombosis research

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.thromres.2020.10.035

    authors: Pancani R,Villari L,Foci V,Parri G,Barsotti F,Patrucco F,Malerba M,Vincenti R,Carrozzi L,Celi A

    更新日期:2021-01-01 00:00:00

  • Increased expression of TFPI in human carotid stenosis.

    abstract:INTRODUCTION:Tissue factor (TF) pathway inhibitor (TFPI) is the physiological inhibitor of TF induced blood coagulation and two isoforms exists, TFPIα and TFPIβ. In atherosclerotic plaques, TFPI may inhibit TF activity and thrombus formation, which is the main cause of ischemic stroke in carotid artery disease. We aime...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2017.04.024

    authors: Stavik B,Holm S,Espada S,Iversen N,Sporsheim B,Bjerkeli V,Dahl TB,Sandset PM,Skjelland M,Espevik T,Skretting G,Halvorsen B

    更新日期:2017-07-01 00:00:00

  • Venous thrombosis at unusual site in women.

    abstract::Several sex-related differences in the incidence rate, clinical presentation and outcomes of VTE were recently investigated. Gender-related risk factors, such as the use of oral contraceptives (OC) and pregnancy, in particular in women with a thrombophilic state, are associated with an increased risk of venous thrombo...

    journal_title:Thrombosis research

    pub_type: 杂志文章,评审

    doi:10.1016/S0049-3848(11)70023-8

    authors: Romualdi E,Ageno W

    更新日期:2011-02-01 00:00:00

  • Identification of four novel polymorphisms in the Aalpha and gamma fibrinogen genes and analysis of association with plasma levels of the protein.

    abstract::Four novel polymorphisms were identified in the fibrinogen gene cluster. Three of them were localized in the promoter regions of the Aalpha-chain (alpha -128 C/G, alpha -58 G/A) or the gamma-chain (gamma -239 A/G) gene, while the remaining one was identified in intron 9 of the gamma-chain gene (gamma 7792 C/T). Genoty...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/s0049-3848(01)00329-2

    authors: Menegatti M,Asselta R,Duga S,Malcovati M,Bucciarelli P,Mannucci PM,Tenchini ML

    更新日期:2001-08-15 00:00:00

  • Lupus anticoagulant identifies two distinct groups of patients with different antibody patterns.

    abstract:BACKGROUND:Whether antibodies directed to β2-Glycoprotein I (aβ2GPI) are responsible for LA activity is not well defined. However, in the absence of such antibodies the molecule responsible for LA phenomenon is unknown. OBJECTIVE:The aim of this study was the biochemical identification of the target antigen epitope of...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2018.11.003

    authors: Pengo V,Del Ross T,Ruffatti A,Bison E,Cattini MG,Pontara E,Testa S,Legnani C,Pozzi N,Peterle D,Acquasaliente L,De Filippis V,Denas G

    更新日期:2018-12-01 00:00:00

  • Release of von Willebrand factor by cardiopulmonary bypass, but not by cardioplegia in open heart surgery.

    abstract::von Willebrand Factor (vWF) is released from endothelial cells. Increased vWF in the coronary circulation during cardiac surgery could be a potential indicator of coronary endothelial injury or stimulation, and thus a possible tool to evaluate regimens of myocardial protection. Release of vWF was investigated in 12 pa...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(94)90050-7

    authors: Valen G,Blombäck M,Sellei P,Lindblom D,Vaage J

    更新日期:1994-01-01 00:00:00

  • To screen or not to screen for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism.

    abstract::Chronic thromboembolic pulmonary hypertension (CTEPH) is the most severe long term complication of acute pulmonary embolism (PE). Untreated, CTEPH is associated with a very poor prognosis and high risk of mortality, although curation can be achieved by surgical removal of the obstructive endothelialised thromboemboli ...

    journal_title:Thrombosis research

    pub_type: 杂志文章,评审

    doi:10.1016/j.thromres.2016.12.026

    authors: Ende-Verhaar YM,Huisman MV,Klok FA

    更新日期:2017-03-01 00:00:00

  • Increased fibrinolytic activity after surgery induced by low dose heparin.

    abstract::Forty women undergoing surgery under general anaesthesia for hyperplasia mammae were randomized to treatment with low dose heparin (5000 IU twice daily) or not. Preoperatively, and repeated on the 3. postoperative day, assays of euglobulin clot lysis time (ELT) after venous stasis, tissue plasminogen activator (t-PA) ...

    journal_title:Thrombosis research

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/0049-3848(87)90318-5

    authors: Arnesen H,Engebretsen LF,Ugland OM,Seljeflot I,Kierulf P

    更新日期:1987-03-01 00:00:00

  • Proaggregatory and inhibitory effects of 2-O-ethyl analogues of platelet-activating factor (PAF) on human and rabbit platelets.

    abstract::A series of 8 analogues of platelet-activating factor (PAF) in which both the acetyl group and the polar head are changed, were tested for biological activities on human and rabbit platelets in plasma. Two of these compounds, 1-O-hexadecyl-2-O-ethyl-rac-glycero-3-phosphoric acid-5'-trimethylammoniumpentyl ester and 1-...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(88)90244-7

    authors: Hofmann B,Ostermann G,Kertscher HP,Till U

    更新日期:1988-02-15 00:00:00

  • Quality of individual INR control and the risk of stroke and bleeding events in atrial fibrillation patients: a nested case control analysis of the ACTIVE W study.

    abstract:INTRODUCTION:Time in therapeutic range (TTR) for international normalized ratio (INR) is an accepted quality measure of anticoagulation control in patient populations, but its usefulness for predicting stroke and bleeding in individuals is not well understood. MATERIALS AND METHODS:In a nested case control analysis am...

    journal_title:Thrombosis research

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.thromres.2011.08.024

    authors: Nieuwlaat R,Connolly BJ,Hubers LM,Cuddy SM,Eikelboom JW,Yusuf S,Connolly SJ,ACTIVE Investigators.

    更新日期:2012-06-01 00:00:00

  • Arterial thrombosis and cancer.

    abstract::Cancer-associated arterial thrombotic events (ATEs) are increasingly recognized in specific malignancies and in association with the expanding armamentarium of novel chemotherapeutic agents. The improved cancer survival led to cardiovascular complications becoming clinically relevant many years after cancer diagnosis....

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2018.01.003

    authors: Aronson D,Brenner B

    更新日期:2018-04-01 00:00:00

  • Brave new world: the current and future use of novel anticoagulants.

    abstract::Advances in antithrombotic therapy began when traditional anticoagulant agents such as heparin and the vitamin K antagonists like Coumadin became commercially available in the 1940s and 1950s. Inherent limitations of these compounds, including the need for monitoring and multiple food and drug interactions (with couma...

    journal_title:Thrombosis research

    pub_type: 杂志文章,评审

    doi:10.1016/j.thromres.2008.08.010

    authors: Spyropoulos AC

    更新日期:2008-01-01 00:00:00

  • Mild hyperhomocysteinemia and fibrinolytic factors in patients with history of venous thromboembolism.

    abstract::Mild hyperhomocysteinemia is recognized as a risk factor for venous thromboembolism (VTE), though its role in the thrombogenic processes is not understood. Its possible association with impaired fibrinolysis was investigated in 157 patients (61 women, 96 men) below the age of 60 years (43+/-11, mean+/-SD) with a histo...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/s0049-3848(00)00324-8

    authors: Bozic M,Stegnar M,Fermo I,Ritonja A,Peternel P,Stare J,D'Angelo A

    更新日期:2000-11-15 00:00:00

  • ATP-secretion occurs as an initial response in collagen induced platelet activation.

    abstract::The time course and degree of collagen induced platelet shape change, aggregation and ATP-secretion in citrated human platelet rich plasma was monitored with a lumi-aggregometer. Onset of ATP-secretion was measurable within seconds after collagen challenge and always distinctly before onset of shape change. In absence...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/0049-3848(86)90089-7

    authors: Malmgren R

    更新日期:1986-08-15 00:00:00

  • Laboratory evaluation of the Coasys® Plus C coagulation analyzer.

    abstract:INTRODUCTION:The Coasys® Plus C (Behnk Elektronik, distributed by Roche Diagnostics) is a coagulation analyzer for small to midsize clinical chemistry laboratories. We performed a laboratory evaluation. MATERIALS AND METHODS:After a familiarization period the dead volume, carry-over, capacity, within-assay reproducibi...

    journal_title:Thrombosis research

    pub_type: 杂志文章

    doi:10.1016/j.thromres.2013.02.004

    authors: de Bie P,Schornagel WJ,van den Dool EJ,Bakker B,van Dam W,Heckman M,Ağar C,Sturk A,Stroobants AK

    更新日期:2013-04-01 00:00:00