[해외논문]
Use of venous thromboembolism prophylaxis for surgical patients: a multicentre analysis of practice in Spain
The European journal of surgery = Acta chirurgica ,
v.167 no.3 ,
2001년, pp.163 - 167
Otero, Remedios
(Services of Pneumology of Hopital Virgen del Rocí)
,
Uresandi, Fernando
(o, Sevilla, Spain)
,
Cayuela, Aurelio
(Services of Pneumology of Hospital de Cruces, Bilbao, Spain)
,
Blanquer, José
(Services of Pneumology of Hopital Virgen del Rocí)
,
Cabezudo, Miguel A.
(o, Sevilla, Spain)
,
De Gregorio, Miguel A.
(Services of Pneumology of Hospital Clí)
,
Lobo, José
(nico Universitario, Valencia, Spain)
,
L.
(Services of Pneumology of Hospital Central de Asturias, Oviedo, Spain)
,
Nauffal, Dolores
(Services of Pneumology of Hospital Clí)
,
Oribe, Mikel
(nico, Zaragoza, Spain)
AbstractObjective:To assess the use of venous thromboembolism prophylaxis in surgical patients.Design:Retrospective multicentre study.Setting:Eight acute‐care teaching hospitals with more than 400 beds, Spain.Patients:Medical records of all consecutive patients undergoing operations in the gen...
AbstractObjective:To assess the use of venous thromboembolism prophylaxis in surgical patients.Design:Retrospective multicentre study.Setting:Eight acute‐care teaching hospitals with more than 400 beds, Spain.Patients:Medical records of all consecutive patients undergoing operations in the general surgical and trauma and orthopaedic services during the month of April, 1997, were randomly selected.Intervention:The sample size for each type of operation (general, trauma‐orthopaedic) was calculated from the number of operations done at each hospital (with an absolute precision of 5%, and an α error of 5%) and the prevalence of the use of venous thromboembolism prophylaxis obtained from a random sample of 50 records (25 from patients in general surgery and 25 from patients in orthopaedic surgery) from each centre.Main outcome measures:Appropriate and inappropriate pharmacological prophylaxis defined according to a combination of risk categories for venous thromboembolism, doses of antithrombotic agents given, time of starting prophylaxis, and its duration.Results:A total of 1848 medical records (general surgery, n = 1025; trauma‐orthopaedic surgery, n = 823) were included. Physical methods (elastic stockings, intermittent pneumatic compression) were used in only 0.3% of patients. Pharmacological prophylaxis consisted of low molecular weight heparin in 99% of cases. The percentage given heparin‐based prophylaxis was 54%. Overall, appropriate prophylaxis was given in 1175 patients (64%). Use of thromboprophylaxis ranged from 27% to 70% among the participating hospitals. Prophylaxis was more likely to be appropiate in orthopaedic patients (577, 70%) than in general surgical patients (598, 58%) in both the high and moderate risk categories.Conclusions:Given the large variability between the participating hospitals, more specific protocols and recommendations about prophylaxis of thromboembolism in surgical patients are needed. Copyright © 2001 Taylor and Francis Ltd.
AbstractObjective:To assess the use of venous thromboembolism prophylaxis in surgical patients.Design:Retrospective multicentre study.Setting:Eight acute‐care teaching hospitals with more than 400 beds, Spain.Patients:Medical records of all consecutive patients undergoing operations in the general surgical and trauma and orthopaedic services during the month of April, 1997, were randomly selected.Intervention:The sample size for each type of operation (general, trauma‐orthopaedic) was calculated from the number of operations done at each hospital (with an absolute precision of 5%, and an α error of 5%) and the prevalence of the use of venous thromboembolism prophylaxis obtained from a random sample of 50 records (25 from patients in general surgery and 25 from patients in orthopaedic surgery) from each centre.Main outcome measures:Appropriate and inappropriate pharmacological prophylaxis defined according to a combination of risk categories for venous thromboembolism, doses of antithrombotic agents given, time of starting prophylaxis, and its duration.Results:A total of 1848 medical records (general surgery, n = 1025; trauma‐orthopaedic surgery, n = 823) were included. Physical methods (elastic stockings, intermittent pneumatic compression) were used in only 0.3% of patients. Pharmacological prophylaxis consisted of low molecular weight heparin in 99% of cases. The percentage given heparin‐based prophylaxis was 54%. Overall, appropriate prophylaxis was given in 1175 patients (64%). Use of thromboprophylaxis ranged from 27% to 70% among the participating hospitals. Prophylaxis was more likely to be appropiate in orthopaedic patients (577, 70%) than in general surgical patients (598, 58%) in both the high and moderate risk categories.Conclusions:Given the large variability between the participating hospitals, more specific protocols and recommendations about prophylaxis of thromboembolism in surgical patients are needed. Copyright © 2001 Taylor and Francis Ltd.
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