Thromboembolism Prophylaxis in Surgical Patients Found Insufficient

A new study reports that about 85% of surgical patients do not receive recommended venous thromboembolism prophylaxis.

Researchers at the University of California at Irvine (USA) reviewed the records of 116,915 surgical patients discharged between January 2002 and December 2006 for the appropriate use of VTE prophylaxis, as defined in the seventh American College of Chest Physicians guidelines. The patients were all aged 40 years and older with a hospital stay of at least six days, and without anticoagulation contraindications.

The study results found that rates of prophylaxis varied widely among surgical groups; when analyzed by type of surgery, appropriate prophylaxis was prescribed in 68% of orthopedic surgery patients, 14.9% of those undergoing vascular surgery; 13.9% of general surgery patients; 12.3% of laparoscopic surgery patients; 6.5% of gynecological surgery patients; 5.2% of urological surgery patients; and 4% of patients undergoing neurological surgery. The study was reported at the 49th annual meeting of the American Society of Hematology, held in Atlanta (GA, USA) during December 2007.

"Only 14.4% of discharged patients received appropriate thromboprophylaxis. Orthopedic surgery patients receive the highest rates, but even a third of that group does not receive treatment according to the guidelines,” concluded Dr. Alpesh Amin and colleagues. "There is a big fear of bleeding, but we have to remember we are using prophylactic dosages, not therapeutic doses of anticoagulants.”

The American College of Chest Physicians guidelines on antithrombotic and thrombolytic therapy for the prevention of venous thromboembolism are available online.


Related Links:
University of California at Irvine
VTE prophylaxis guidelines