Significant practice variability exists in the prevention of venous thromboembolism in injured children: results from a joint survey of the Pediatric Trauma Society and the Trauma Center Association of America.
Pediatr Surg Int
; 36(7): 809-815, 2020 Jul.
Article
em En
| MEDLINE
| ID: mdl-32488401
ABSTRACT
BACKGROUND/PURPOSE:
The purpose of this study was to characterize current practices to prevent venous thromboembolism (VTE) in children and measure adherence to recent joint consensus guidelines from the Pediatric Trauma Society and Eastern Association for the Surgery of Trauma (PTS/EAST).METHODS:
An 18-question survey was sent to the membership of PTS and the Trauma Center Association of American. Responses were compared with Chi-square test.RESULTS:
One hundred twenty-nine members completed the survey. Most respondents were from academic (84.5%), Level 1 pediatric (62.0%) trauma centers. Criteria for VTE prophylaxis varied between hospitals with freestanding pediatric trauma centers significantly more likely to stratify children by risk factors than adult trauma centers (p = 0.020). While awareness of PTS/EAST guidelines (58.7% overall) was not statistically different between hospital types (44% freestanding adult, 52% freestanding pediatric, 71% combined adult pediatric, p = 0.131), self-reported adherence to these guidelines was uniformly low at 37.2% for all respondents. Lastly, in three clinical scenarios, respondents chose VTE screening and prophylaxis plans in accordance with a prospective application of PTS/EAST guidelines 55.0% correctly.CONCLUSION:
Currently no consensus regarding the prevention of VTE in pediatric trauma exists. Prospective application of PTS/EAST guidelines has been limited, likely due to poor quality of evidence and a reliance on post-injury metrics. Results of this survey suggest that further investigation is needed to more clearly define the risk of VTE in children, evaluate, and prospectively validate alternative scoring systems for VTE prevention in injured children. LEVEL OF EVIDENCE N/A-Survey.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Centros de Traumatologia
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Ferimentos e Lesões
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Padrões de Prática Médica
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Pesquisas sobre Atenção à Saúde
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Tromboembolia Venosa
Tipo de estudo:
Etiology_studies
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Guideline
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Adult
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Child
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Female
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Humans
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Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article