Impact of an integrated hospital-community care pathway on the management of venous thromboembolism: the venous thromboembolic disease care pathway 93 study.

Authors

Jérémy Datchanamourty, Antonio Morabito, Raphael Lhote, Siwar Hammami, Nanthara Sritharan, Matthieu Plichart, Sylvain Le Jeune

Published in

Research and practice in thrombosis and haemostasis. Volume 10. Issue 7. Pages 106956. Epub Sep 12, 2026.

Abstract

Venous thromboembolism (VTE) carries a high risk of recurrence and bleeding complications. Care transitions represent a vulnerable period, particularly in medically underserved areas where loss to follow-up is common. Integrated hospital-community care pathways may improve outcomes, but data are limited.
To evaluate whether an integrated hospital-community care pathway for patients with venous thromboembolism was associated with improved clinical outcomes and continuity of care compared with standard care.
We conducted a single-center, retrospective, observational study of 161 consecutive patients managed for VTE in the day hospital at Avicenne Hospital (Bobigny, France) from December 2022 to December 2024. Patients enrolled in a structured city hospital care pathway (n = 64) were compared with those receiving standard care (n = 97). The primary endpoint was a composite of thrombotic recurrence, bleeding, hospitalization, or death. Inverse probability of treatment weighting was used to address confounding.
The structured pathway was associated with a lower risk of the primary composite endpoint (hazard ratio [HR], 0.44; 95% CI, 0.21-0.93; P = .03), consistent with the inverse probability of treatment weighting analysis (HR, 0.44; 95% CI, 0.21-0.92; P = .03). Loss to follow-up was markedly lower in the structured pathway group (7.8% vs 30%; P = .002), and patients lost to follow-up had a 3.5-fold higher risk of complications (HR, 3.50; 95% CI, 1.71-7.18; P < .001). Enrollment in the pathway was associated with lower odds of loss to follow-up (odds ratio, 0.21; 95% CI, 0.07-0.53; P = .002).
In this single-center, retrospective cohort study, a structured city hospital care pathway was associated with a lower risk of composite complications and a lower loss-to-follow-up rate among patients managed for VTE. These findings support the potential value of integrated care coordination pathways, particularly in medically underserved areas.

PMID:
42893264
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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