Venous thromboembolism prophylaxis in thoracic surgery patients: an international survey

被引:12
作者
Shargall, Yaron [1 ]
Brunelli, Alessandro [2 ]
Murthy, Sudish [3 ]
Schneider, Laura [1 ]
Minervini, Fabrizio [4 ]
Bertolaccini, Luca [5 ]
Agzarian, John [1 ]
Linkins, Lori-Ann [6 ]
Kestenholz, Peter [4 ]
Li, Hui [7 ]
Rocco, Gaetano [8 ]
Girard, Philippe [9 ]
Venuta, Federico [10 ]
Samama, Marc [11 ,12 ]
Scarci, Marco [13 ]
Anraku, Masaki [14 ]
Falcoz, Pierre-Emmanuel [15 ]
Kirk, Alan [16 ]
Solli, Piergiorgio [5 ]
Hofstetter, Wayne [17 ]
Okumura, Meinoshin [18 ]
Douketis, James [6 ]
Litle, Virginia [19 ]
机构
[1] McMaster Univ, Dept Surg, 50 Charlton Ave East T-2105, Hamilton, ON L8N 4A6, Canada
[2] St James Univ Hosp, Dept Thorac Surg, Leeds, W Yorkshire, England
[3] Cleveland Clin, Dept Thorac & Cardiovasc Surg, Cleveland, OH 44106 USA
[4] Kantonsspital Luzern, Dept Thorac Surg, Luzern, Switzerland
[5] Maggiore Hosp, Dept Thorac Surg, Bologna, Italy
[6] McMaster Univ, Dept Med, Hamilton, ON, Canada
[7] Capital Med Univ, Dept Thorac Surg, Beijing, Peoples R China
[8] Univ Hosp Leuven, Dept Thorac Surg, Leuven, Belgium
[9] Inst Mutualiste Montsouris, Thorac Dept, Paris, France
[10] Mem Sloan Kettering Canc Ctr, Dept Thorac Surg, 1275 York Ave, New York, NY 10021 USA
[11] Cochin Univ Hosp, Dept Anaesthesia & Intens Care Med, Paris, France
[12] Hotel Dieu Univ Hosp, Dept Anaesthesia & Intens Care Med, Paris, France
[13] San Gerardo Hosp, Dept Thorac Surg, Monza, Italy
[14] Univ Tokyo, Dept Thorac Surg, Grad Sch Med, Tokyo, Japan
[15] Univ Hosp Strasbourg, Dept Thorac Surg, Strasbourg, France
[16] Golden Jubilee Natl Hosp, Dept Cardiothorac Surg, Glasgow, Lanark, Scotland
[17] Univ Texas MD Anderson Canc Ctr, Dept Thorac & Cardiovasc Surg, Houston, TX 77030 USA
[18] Osaka Univ, Dept Gen Thorac Surg, Grad Sch Med, Osaka, Japan
[19] Boston Univ, Sch Med, Dept Surg, Boston, MA 02118 USA
关键词
Venous thromboembolism; Prophylaxis; Thoracic surgery; Guidelines; International; Survey; ARTERY STUMP THROMBOSIS; PRACTICE PATTERNS; RISK-FACTORS; LUNG-CANCER; PREVENTION; VTE; PNEUMONECTOMY; COMPLICATIONS; RESECTION; ONCOLOGY;
D O I
10.1093/ejcts/ezz191
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES Venous thromboembolic events (VTE) after thoracic surgery (TS) can be prevented with mechanical and chemical prophylaxis. Unlike other surgical specialties, TS lacks evidence-based guidelines. In the process of developing these guidelines, an understanding of the current prophylaxis methods practiced internationally is necessary and is described in this article. METHODS A 26-item survey was distributed to members of the European Society of Thoracic Surgeons (ESTS), American Association of Thoracic Surgery (AATS), Japanese Association for Chest Surgery (JACS) and Chinese Society for Thoracic and Cardiovascular Surgery (CSTCS) electronically or in person. Participants were asked to report their current prophylaxis selection, timing of initiation and duration of prophylaxis, perceived risk factors and the presence and adherence to institutional VTE guidelines for patients undergoing TS for malignancies. RESULTS In total, 1613 surgeons anonymously completed the survey with an overall 36% response rate. Respondents were senior surgeons working in large academic hospitals (>= 70%, respectively). More than 83.5% of ESTS, AATS and JACS respondents report formal TS thromboprophylaxis protocols in their institutions, but 53% of CSTCS members report not having such a protocol. The regions varied in the approaches utilized for VTE prophylaxis, the timing of initiation perioperatively and the use and type of extended prophylaxis. Respondents reported that multiple risk factors and sources of information impact their VTE prophylaxis decision-making processes, and these factors vastly diverge regionally. CONCLUSIONS There is little agreement internationally on the optimal approach to thromboprophylaxis in the TS population, and guidelines will be helpful and vastly welcomed.
引用
收藏
页码:331 / 337
页数:7
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