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10 results on '"Allison J. Lazenby"'

1. Evaluation of a Risk-Stratified, Heparin-Based, Obstetric Thromboprophylaxis Protocol

Author

Akila Subramaniam, Elisa T. Bushman, Elizabeth B Ausbeck, Dhong-Jin Kim, Michelle Y. Lu, Martha F. Ruzic, Macie L. Champion, Brian M. Casey, Gabriella D. Cozzi, Jeff M. Szychowski, Kacie R. Oglesby, Sarah A. Dunk, Rodrigo D.D. Muñoz Rogers, Margaret R Page, Mythreyi Mahalingam, Allison J. Lazenby, Alan T.N. Tita, Christina T Blanchard, and Elle R. Kaplan

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Obstetrics, Population, Obstetrics and Gynecology, Retrospective cohort study, Heparin, Newly diagnosed, Odds ratio, Surgical procedures, Tertiary care, medicine, business, education, Venous thromboembolism, medicine.drug
Abstract

Objective To evaluate outcomes before and after implementation of a risk-stratified heparin-based obstetric thromboprophylaxis protocol. Methods We performed a retrospective cohort study of all patients who delivered at our tertiary care center from 2013 to 2018. Deliveries were categorized as preprotocol (2013-2015; no standardized heparin-based thromboprophylaxis) and postprotocol (2016-2018). Patients receiving outpatient anticoagulation for active venous thromboembolism (VTE) or high VTE risk were excluded. Coprimary effectiveness and safety outcomes were postpartum VTEs and wound hematomas, respectively, newly diagnosed after delivery and up to 6 weeks postpartum. Secondary outcomes were other wound or bleeding complications, including unplanned surgical procedures (eg, hysterectomies, wound explorations) and blood transfusions. Outcomes were compared between groups, and adjusted odds ratios (aORs) and 95% CIs were calculated using the preprotocol group as reference. Results Of 24,229 deliveries, 11,799 (49%) occurred preprotocol. Although patients were more likely to receive heparin-based prophylaxis postprotocol (15.6% vs 1.2%, P Conclusion Risk-stratified heparin-based thromboprophylaxis in a general obstetric population was associated with increased wound and bleeding complications without a complementary decrease in postpartum VTE. Guidelines recommending this strategy should be reconsidered.

Published
2021

2. Evaluation of a Risk-Stratified, Heparin-Based, Obstetric Thromboprophylaxis Protocol

Author

Michelle Y, Lu, Christina T, Blanchard, Elizabeth B, Ausbeck, Kacie R, Oglesby, Margaret R, Page, Allison J, Lazenby, Gabriella D, Cozzi, Rodrigo D, Muñoz Rogers, Elisa T, Bushman, Elle R, Kaplan, Martha F, Ruzic, Mythreyi, Mahalingam, Sarah, Dunk, Macie, Champion, Brian M, Casey, Alan T, Tita, Dhong-Jin, Kim, Jeff M, Szychowski, and Akila, Subramaniam

Subjects
Adult, Hematoma, Heparin, Postpartum Hemorrhage, Pregnancy Complications, Cardiovascular, Anticoagulants, Venous Thromboembolism, Delivery, Obstetric, Young Adult, Postoperative Complications, Pregnancy, Risk Factors, Humans, Blood Transfusion, Female, Program Evaluation, Retrospective Studies
Abstract

To evaluate outcomes before and after implementation of a risk-stratified heparin-based obstetric thromboprophylaxis protocol.We performed a retrospective cohort study of all patients who delivered at our tertiary care center from 2013 to 2018. Deliveries were categorized as preprotocol (2013-2015; no standardized heparin-based thromboprophylaxis) and postprotocol (2016-2018). Patients receiving outpatient anticoagulation for active venous thromboembolism (VTE) or high VTE risk were excluded. Coprimary effectiveness and safety outcomes were postpartum VTEs and wound hematomas, respectively, newly diagnosed after delivery and up to 6 weeks postpartum. Secondary outcomes were other wound or bleeding complications, including unplanned surgical procedures (eg, hysterectomies, wound explorations) and blood transfusions. Outcomes were compared between groups, and adjusted odds ratios (aORs) and 95% CIs were calculated using the preprotocol group as reference.Of 24,229 deliveries, 11,799 (49%) occurred preprotocol. Although patients were more likely to receive heparin-based prophylaxis postprotocol (15.6% vs 1.2%, P.001), there was no difference in VTE frequency between groups (0.1% vs 0.1%, odds ratio 1.0, 95% CI 0.5-2.1). However, patients postprotocol experienced significantly more wound hematomas (0.7% vs 0.4%, aOR 2.34, 95% CI 1.54-3.57), unplanned surgical procedures (aOR 1.29, 95% CI 1.06-1.57), and blood transfusions (aOR 1.34, 95% CI 1.16-1.55).Risk-stratified heparin-based thromboprophylaxis in a general obstetric population was associated with increased wound and bleeding complications without a complementary decrease in postpartum VTE. Guidelines recommending this strategy should be reconsidered.

Published
2021

3. 59 Safety and efficacy of a risk-based obstetric heparin-based thromboprophylaxis regimen

Author

Mythreyi Mahalingam, Dhong-Jin Kim, Martha F. Ruzic, Allison J. Lazenby, Michelle Y. Lu, Jeff M. Szychowski, Christina T. Blanchard, Gabriella D. Cozzi, Kacie R. Oglesby, Elle R. Kaplan, Macie L. Champion, Sarah A. Dunk, Margaret R. Page, Akila Subramaniam, Elizabeth B. Ausbeck, Elisa T. Bushman, Brian M. Casey, Alan T.N. Tita, and Rodrigo D.D. Muñoz Rogers

Subjects
medicine.medical_specialty, Regimen, business.industry, medicine, Obstetrics and Gynecology, Heparin, Intensive care medicine, business, medicine.drug
Published
2021

4. 358 VTE timing with routine heparin-based anticoagulation for inpatient obstetric thromboprophylaxis

Author

Dhong-Jin Kim, Elisa T. Bushman, Jeff M. Szychowski, Martha F. Ruzic, Kacie R. Oglesby, Akila Subramaniam, Macie L. Champion, Margaret R. Page, Allison J. Lazenby, Mythreyi Mahalingam, Gabriella D. Cozzi, Michelle Y. Lu, Christina T. Blanchard, Elizabeth B. Ausbeck, Sarah A. Dunk, Elle R. Kaplan, Brian M. Casey, Alan T.N. Tita, and Rodrigo D.D. Muñoz Rogers

Subjects
medicine.medical_specialty, business.industry, Obstetrics and Gynecology, Medicine, Heparin, business, Intensive care medicine, medicine.drug
Published
2021

5. 764 Operative vaginal delivery as an independent risk factor for maternal postpartum infection

Author

Kacie R. Oglesby, Elle R. Kaplan, Brian M. Casey, Macie L. Champion, Alan T.N. Tita, Dhong-Jin Kim, Akila Subramaniam, Rodrigo D.D. Muñoz Rogers, Jeff M. Szychowski, Martha F. Ruzic, Elisa T. Bushman, John Owen, Gabriella D. Cozzi, Margaret R. Page, Mythreyi Mahalingham, Michelle Y. Lu, Elizabeth B. Ausbeck, Christina T. Blanchard, Allison J. Lazenby, and Sarah A. Dunk

Subjects
medicine.medical_specialty, business.industry, Vaginal delivery, Obstetrics, Postpartum infection, Obstetrics and Gynecology, Medicine, Risk factor, business
Published
2021

6. 582 Post-cesarean infections before and after implementation of adjunctive azithromycin in addition to standard antibiotics

Author

Kacie R. Oglesby, Margaret R. Page, Macie L. Champion, Sarah A. Dunk, Rodrigo D.D. Muñoz Rogers, Dhong-Jin Kim, Michelle Y. Lu, Jeff M. Szychowski, Gabriella D. Cozzi, Lindsay S. Robbins, Christina T. Blanchard, Brian M. Casey, Martha F. Ruzic, Alan T.N. Tita, Elisa T. Bushman, Mythreyi Mahalingam, Allison J. Lazenby, Elizabeth B. Ausbeck, and Akila Subramaniam

Subjects
medicine.medical_specialty, business.industry, medicine.drug_class, Internal medicine, Antibiotics, Obstetrics and Gynecology, Medicine, business, Azithromycin, medicine.drug
Published
2021

7. 390: Impact of a risk-based thromboprophylaxis protocol on postpartum bleeding and healthcare resource utilization

Author

Akila Subramaniam, Alan T.N. Tita, Dhong-Jin Kim, Lorie M. Harper, Rodrigo D. Muñoz, Margaret R. Page, Victoria C. Jauk, Brian M. Casey, Michelle Y. Lu, Kacie R. Oglesby, Allison J. Lazenby, Jeff M. Szychowski, and Elizabeth B. Ausbeck

Subjects
Protocol (science), medicine.medical_specialty, postpartum bleeding, business.industry, Health care, medicine, Obstetrics and Gynecology, medicine.disease, Intensive care medicine, business, Resource utilization
Published
2020

9. 823 African-American race and subsequent pregnancy outcomes after a prior preterm birth

Author

Gabriella D. Cozzi, Macie L. Champion, Kacie R. Oglesby, Elle R. Kaplan, Mythreyi Mahalingam, Brian M. Casey, Alan T.N. Tita, Michelle Y. Lu, Martha F. Ruzic, Rodrigo D.D. Muñoz Rogers, Christina T. Blanchard, Margaret R. Page, Sarah A. Dunk, Allison J. Lazenby, Elisa T. Bushman, Jeff M. Szychowski, Elizabeth B. Ausbeck, and Akila Subramaniam

Subjects
African american, Race (biology), business.industry, Obstetrics and Gynecology, Medicine, Subsequent pregnancy, business, Demography
Published
2021

10. 510 Contemporary trends in cesarean delivery rates and indications

Author

Elisa T. Bushman, Elle R. Kaplan, Michelle Y. Lu, Christina T. Blanchard, Akila Subramaniam, Margaret R. Page, Sara Jaber, Dhong-Jin Kim, Martha F. Ruzic, Brian M. Casey, Alan T.N. Tita, Kacie R. Oglesby, Rodrigo D.D. Muñoz Rogers, Elizabeth B. Ausbeck, Macie L. Champion, Jeff M. Szychowski, Sarah A. Dunk, Mythreyi Mahalingam, Allison J. Lazenby, and Gabriella D. Cozzi

Subjects
medicine.medical_specialty, business.industry, Obstetrics, Obstetrics and Gynecology, Medicine, Cesarean delivery, business
Published
2021

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