An Assessment of Surgical Thromboprophylaxis in a Tertiary Care Center
| Autor: | Cassianne Robinson-Cohen, Vicky Tagalakis, Marie-France Dubois, Danielle Pilon |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Immunology Logistic regression Biochemistry Tertiary care Cohort Studies Health care medicine Humans Medical prescription Intensive care medicine Retrospective Studies business.industry Incidence (epidemiology) Anticoagulants Retrospective cohort study Venous Thromboembolism Cell Biology Odds ratio Hematology General Medicine Middle Aged medicine.disease Confidence interval Pulmonary embolism Surgical Procedures Operative Emergency medicine Cohort Female business Venous thromboembolism |
| Zdroj: | Clinical and Applied Thrombosis/Hemostasis. 17:E39-E45 |
| ISSN: | 1938-2723 1076-0296 |
| DOI: | 10.1177/1076029610382652 |
| Popis: | Background. Venous thromboembolism (VTE) is a frequent surgical complication. The type of surgery and baseline patient VTE risk factors are important in defining postoperative VTE risk. The 2004 American College of Chest Physicians (ACCP) recommends implementation of pharmacologic thromboprophylaxis according to surgery type and VTE risk factors. We conducted a retrospective cohort study of surgical patients to determine adherence to the 2004 ACCP surgical thromboprophylaxis recommendations and to assess for predictors of non-adherence. Methods. Using data from the administrative healthcare database CIRESSS (Centre Informatisé de Recherche Évaluative en Services en Soins de Santé), in patients admitted for surgery between January 1st and December 31st 2006 at the Centre Hospitalier Universitaire de Sherbrooke (CHUS), a tertiary care center in Sherbrooke, Quebec, Canada, we retrospectively assembled a cohort of all consecutively admitted surgical patients who met ACCP criteria for pharmacologic thromboprophylaxis. We assessed the proportion of patients who received in the 24 hours pre- and post-surgery a prescription for thromboprophylaxis. We used conditional logistic regression to determine clinical characteristics associated with an absent prescription. The incidence of objectively-defined symptomatic postoperative VTE was assessed at three months. Results. Of 2286 surgical admissions that met ACCP recommendations for pharmacologic thromboprophylaxis, 1852 (81%) received thromboprophylaxis and 434 (19%) did not. Male sex (odds ratio (OR): 1.9, 95% confidence interval (CI) (1.4–2.4)), age Conclusions. Though surgical thromboprophylaxis was observed in 81% of surgical patients, 19% of patients who met criteria for ACCP thromboprophylaxis did not receive prophylaxis. Targeted recommendations in particular toward pregnant women undergoing non-obstetrical surgery, patients with short duration hospitalization, and patients undergoing non-orthopaedic surgery may ameliorate thromboprophylaxis compliance rates, which in turn may impact on post-operative VTE risk. |
| Databáze: | OpenAIRE |
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