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Cystic fibrosis and sickle cell disease associated with nonadministration of VTE prophylaxis in hospitalized adults

Year: 2026

Type: article

Abstract: ABSTRACT: Cystic fibrosis (CF) and sickle cell disease (SCD) are associated with an increased risk of venous thromboembolism (VTE), and this risk is exacerbated by hospitalization. VTE prophylaxis nonadministration is a VTE risk factor. The objective of this study was to characterize VTE prophylaxis nonadministration among patients with either CF or SCD compared with medically ill patients without CF or SCD. We conducted a single-center retrospective cohort study of hospitalized patients who were prescribed at least 2 doses of pharmacologic VTE prophylaxis. The primary outcome was the proportion of nonadministered VTE prophylaxis doses by cohort. Multivariable logistic regression was used to identify characteristics associated with nonadministration. A total of 13 316 patients were included, comprising 89 with CF, 246 with SCD, and 12 981 otherwise medically ill. During the study period, 95 697 doses were prescribed; nonadministration rates were 61.8% in the CF cohort, 32.7% in the SCD cohort, and 19.7% in the medically ill cohort (P< .01). In the multivariable logistic regression, CF or SCD diagnosis (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.59-2.6), multiple admissions (OR, 2.4; 95% CI, 2.19-2.64), and >5 prescribed doses of VTE prophylaxis (OR, 2.48; 95% CI, 2.29-2.69) were associated with nonadministration of ≥1 dose. The percent of missed doses (median interquartile range [IQR]) per patient was highest in the CF cohort (66.7% [84.5]), followed by the SCD cohort (10.6% [50]), and medically ill cohort (0% [16.7]; P< .01). These findings suggest strategies to improve VTE prophylaxis administration rates during acute hospitalization in high-risk conditions such as CF and SCD are needed.

Source: Blood Advances

DOI: 10.1182/bloodadvances.2025019297