Literature DB >> 17554579

Risk-based evaluation of thromboprophylaxis among surgical inpatients: are low risk patients treated unnecessarily?

G Roche-Nagle1, J Curran, D J Bouchier-Hayes, S Tierney.   

Abstract

BACKGROUND: Venous thromboembolism is a common source of morbidity and mortality but a variety of preventative measures are available. AIMS: To audit the current practice of thromboprophylaxis and compare against published protocols.
METHODS: Three-hundred and seventy-six (376) surgical patients were surveyed prospectively. A Performa was completed recording the presence of up to 11 risk factors. A risk score was calculated and the use of specific thromboprophylatic measures identified.
RESULTS: Heparin thromboprophylaxis was widely used, eight patients (who were on aspirin therapy) failed to receive any prophylaxis (risk factors 4-6). In addition there were 60 patients at low risk (risk score <2) received LMWH from which they were unlikely to benefit.
CONCLUSIONS: Thromboembolic prophylaxis is widely but unselectively applied. Adoption of a risk: benefit ratio approach should ensure those who would benefit from thromboprophylaxis are adequately treated while those in whom thromboprophylaxis is not indicated are spared unnecessary therapy.

Entities:  

Mesh:

Year:  2007        PMID: 17554579     DOI: 10.1007/s11845-007-0049-3

Source DB:  PubMed          Journal:  Ir J Med Sci        ISSN: 0021-1265            Impact factor:   1.568


  24 in total

Review 1.  Prevention of venous thromboembolism.

Authors:  W H Geerts; J A Heit; G P Clagett; G F Pineo; C W Colwell; F A Anderson; H B Wheeler
Journal:  Chest       Date:  2001-01       Impact factor: 9.410

2.  Subcutaneous heparin versus low-molecular-weight heparin as thromboprophylaxis in patients undergoing colorectal surgery: results of the canadian colorectal DVT prophylaxis trial: a randomized, double-blind trial.

Authors:  R S McLeod; W H Geerts; K W Sniderman; C Greenwood; R C Gregoire; B M Taylor; R E Silverman; K G Atkinson; M Burnstein; J C Marshall; C J Burul; D R Anderson; T Ross; S R Wilson; P Barton
Journal:  Ann Surg       Date:  2001-03       Impact factor: 12.969

3.  Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery.

Authors:  P Mismetti; S Laporte; J Y Darmon; A Buchmüller; H Decousus
Journal:  Br J Surg       Date:  2001-07       Impact factor: 6.939

4.  Clinical guidelines.

Authors:  E West; J Newton
Journal:  BMJ       Date:  1997-08-09

5.  Low molecular weight heparin and unfractionated heparin in thrombosis prophylaxis after major surgical intervention: update of previous meta-analyses.

Authors:  A Koch; S Bouges; S Ziegler; H Dinkel; J P Daures; N Victor
Journal:  Br J Surg       Date:  1997-06       Impact factor: 6.939

Review 6.  Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of subcutaneous heparin. Overview of results of randomized trials in general, orthopedic, and urologic surgery.

Authors:  R Collins; A Scrimgeour; S Yusuf; R Peto
Journal:  N Engl J Med       Date:  1988-05-05       Impact factor: 91.245

7.  Still missing the boat with fatal pulmonary embolism.

Authors:  T E Gillies; C V Ruckley; S J Nixon
Journal:  Br J Surg       Date:  1996-10       Impact factor: 6.939

8.  The long-term clinical course of acute deep venous thrombosis.

Authors:  P Prandoni; A W Lensing; A Cogo; S Cuppini; S Villalta; M Carta; A M Cattelan; P Polistena; E Bernardi; M H Prins
Journal:  Ann Intern Med       Date:  1996-07-01       Impact factor: 25.391

9.  Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin.

Authors:  T E Warkentin; M N Levine; J Hirsh; P Horsewood; R S Roberts; M Gent; J G Kelton
Journal:  N Engl J Med       Date:  1995-05-18       Impact factor: 91.245

Review 10.  Measuring the outcomes and pharmacoeconomic consequences of venous thromboembolism prophylaxis in major orthopaedic surgery.

Authors:  Sean D Sullivan; Susan R Kahn; Bruce L Davidson; Lars Borris; Patrick Bossuyt; Gary Raskob
Journal:  Pharmacoeconomics       Date:  2003       Impact factor: 4.981

View more
  1 in total

1.  Prophylaxis of venous thromboembolism in general surgery: guidelines differ and we still need local policies.

Authors:  D Veeramootoo; L Harrower; R Saunders; D Robinson; W B Campbell
Journal:  Ann R Coll Surg Engl       Date:  2011-07       Impact factor: 1.891

  1 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.