Underuse of venous thromboembolism prophylaxis for general surgery patients: physician practices in the community hospital setting.
Arch Intern Med
; 158(17): 1909-12, 1998 Sep 28.
Article
de En
| MEDLINE
| ID: mdl-9759687
ABSTRACT
BACKGROUND:
Venous thromboembolism is a common complication of surgery. Although surveys of physician self-reported practices have suggested near universal support for routine use of measures to prevent venous thromboembolism, medical record auditing has demonstrated underuse.OBJECTIVE:
To assess physician practices of venous thromboembolism prophylaxis in the community hospital setting.METHODS:
Retrospective review of the medical records from 20 hospitals in Oklahoma of 419 Medicare patients aged 65 years or older undergoing major abdominothoracic surgery between April 1 and December 31, 1995. Utilization rates of prophylaxis stratified according to patient risk for venous thromboembolism were measured.RESULTS:
Prophylaxis measures were implemented for only 160 (38%) of 419 patients studied (95% confidence interval, 33%-43%). There was little variation in the use of prophylaxis based on the risk for venous thromboembolism. Only 97 (39%) of 250 patients (95% confidence interval, 33%-45%) at very high risk received any form of prophylaxis and of these 97, only 64 patients (66%) received appropriate measures (95% confidence interval, 56%-75%).CONCLUSIONS:
Despite widely disseminated, evidence-based recommendations, venous thromboembolism prophylaxis is underused in Medicare patients undergoing major abdominothoracic surgery in community hospitals in Oklahoma.
Recherche sur Google
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Thromboembolie
/
Types de pratiques des médecins
/
Procédures de chirurgie thoracique
/
Abdomen
/
Anticoagulants
Type d'étude:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Pays/Région comme sujet:
America do norte
Langue:
En
Journal:
Arch Intern Med
Année:
1998
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique