Venous thromboprophylaxis in general surgery ward admissions: strategies for improvement

Galante, Mariana; Languasco, Agustín; Gotta, Daniel; Bell, Soledad; Lancelotti, Tomás; Knaze, Viktoria; Saubidet, Cristián López; Grand, Bénédicte Le; Milberg, Matías

doi:10.1093/intqhc/mzs052

Cited by 12 publications

(9 citation statements)

References 23 publications

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“…Un enfoque estratifica a los pacientes quirúrgicos, asignándolos a uno de los cuatro niveles de riesgo de TEV, basado en el tipo de operación (menor y mayor), edad (< 40 años, 40-60 años y > 60 años) y la presencia de factores de riesgo adicionales, siendo todos elementos poco objetivos. 2,4 La escala de Caprini es simple y distingue de manera adecuada el riesgo tromboembólico; también ha sido validada en cirugía general, vascular, urológica y plástica. Recomendaciones del ACCP, con base en diferentes estudios, han demostrado que el puntaje de Caprini representa una estrategia profiláctica basada en el riesgo específico para cada paciente.…”

Section: Discussionunclassified

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Uso inadecuado de tromboprofilaxis en pacientes postquirúrgicos en cirugía general

Maiocco¹,

Nava²,

Moreno³

2020

Acta Médica Grupo Ángeles

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Section: Discussionunclassified

“…El riesgo asociado con la TEV en cirugía general varía entre 10 y 50%, dependiendo del tipo de cirugía y de los factores de riesgo del paciente. [2][3][4]…”

Section: Correspondenciaunclassified

Uso inadecuado de tromboprofilaxis en pacientes postquirúrgicos en cirugía general

Maiocco¹,

Nava²,

Moreno³

2020

Acta Médica Grupo Ángeles

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“…For example, one multistrategy intervention included simplification of an institution's clinical practice guidelines, distribution of pocket cards with an algorithm for the implementation of the new recommendations to both physicians and nurses, educational talks, paper-based reminders, as well as audit and feedback. 54 None of the approaches for transferring evidence to practice seems to be much superior to other approaches. 55 Assessments of different implementation strategies lead to the inference that it is not only the strategy that matters but also the intensity of the implementation.…”

Section: Physician Acceptance Of and Adherence To Clinical Practice Gmentioning

confidence: 99%

Clinical Practice Guidelines and Practice Parameters for the Child Neurologist

2013

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Guidance about how to practice child neurology has been around for decades. Recently, however, clinical practice guidelines, practice parameters, and standardized clinical assessment and management plans are gaining increasing attention. This overview, written for child neurologists, addresses such issues as the following: what are clinical practice guidelines, why are they needed, how are they created, how should they be created, how well are they accepted and adhered to, what influences acceptance and adherence, do guidelines improve care, do they reduce costs, will they be viewed by courts as the standard of care, how can they be updated and improved, and are there better alternatives?

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“…According to recent reports, the overall compliance with international guidelines concerning VTE prophylaxis was nearly 38% in the Middle Eastern countries, with wide geographical disparity [ 14 ]. In comparison to the countries included in the ENDORSE study [ 7 ]; the compliance to VTE prophylaxis guidelines was 68% in the USA, 54% in India, 55% in Kuwait, 81% in Germany, 60% in France, 34% in Egypt, 50% in Algeria, and 31% in Argentina [ 18 ]. However, the data on the degree of compliance with the current antithrombotic guidelines in the Middle East region is still scarce [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional, multicenter, observational study to assess the prophylaxis of venous thromboembolism in Lebanese and Jordanian hospitals

et al. 2021

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Background There is a growing body of evidence showing substantial underuse of appropriate venous thromboembolism (VTE) prophylaxis in patients at risk. In the present study, our goal was to assess the current practices in the use rate of VTE prophylaxis among hospitalized patients in Jordan and Lebanon. Methods A cross-sectional, multicenter, observational study was conducted on 40 centers across Lebanon and Jordan. We included patients who were admitted to the participating hospitals for the treatment of a serious medical or surgical illness. The patients’ records were screened for the fulfillment of inclusion/exclusion criteria during a single assessment visit. The proportion of medical and surgical patients who were at risk of VTE and the thrombo-prophylactic measures employed by physicians for these patients were assessed according to the American College of Chest Physicians (ACCP 2016) guidelines. Results The present study included 704 patients (400 from Jordan and 304 from Lebanon) with a mean age of 54.9 ± 17.5 years. Almost 59% of the patients received prophylaxis treatment in form of pharmacological anticoagulant prophylaxis and/or mechanical prophylaxis. Low molecular weight heparin was the most commonly used anticoagulant for VTE prophylaxis in 366 out of the total 704 (51.9%) patients in the analysis cohort. Two hundred and sixteen patients (52, 95% confidence interval [47.1–56.9%]) received appropriate prophylactic agents out of 415 patients who were eligible for prophylaxis according to the ACCP 2016 guidelines. On the other hand, 199 (72.1, 95% confidence interval [66.4–77.3%) patients received prophylaxis out of 276 ineligible patients. The rate of compliance to guidelines showed wide variations according to the type of hospital, specialty, and the patients’ age. The multivariate logistic regression analysis showed that only age was a significant predictor of appropriate VTE prophylaxis (odds ratio [OR] 1.05, P < 0.001). Conclusion The rates of the appropriate use of VTE prophylaxis are low in Lebanon and Jordan. There is a lack of compliance to guidelines for VTE prophylaxis use for hospitalized patients in both countries.

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Venous thromboprophylaxis in general surgery ward admissions: strategies for improvement

Abstract: Simple and economical interventions such as those described in this study can improve general surgeons compliance with the institutional and international guidelines, thus assuring patient safety and quality of health care.

Cited by 12 publications

References 23 publications

Uso inadecuado de tromboprofilaxis en pacientes postquirúrgicos en cirugía general

Uso inadecuado de tromboprofilaxis en pacientes postquirúrgicos en cirugía general

Clinical Practice Guidelines and Practice Parameters for the Child Neurologist

A cross-sectional, multicenter, observational study to assess the prophylaxis of venous thromboembolism in Lebanese and Jordanian hospitals

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