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October 28, 2008International Journal of SurgeryOpen Access

Prevention of venous thromboembolism: Improving practice in surgical patients

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Key result

Implementation of a VTE protocol within a clerking proforma for acute surgical admissions increased appropriate VTE prophylaxis from 37% to 88% (p<0.001).

Why the study?

Does a VTE prevention protocol within a clerking proforma improve appropriate thromboprophylaxis in acute surgical admissions?

Population

111 acutely admitted surgical inpatients (51 in Round 1, 60 in Round 2) at a district general hospital.

Comparison

VTE prevention protocol incorporating risk… vs Standard practice prior to protocol…

Design

Cohort

Authors

GMGráinne McKennaBarts Health NHS TrustAKA. KarthikesalingamSt George's HospitalSWStewart R. WalshVascular Medicine

Discussion

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Overview

May enhance VTE prophylaxis in acute surgical admissions; hypothesis-generating and requires prospective trials before practice change.

Structured PICO

Does a VTE prevention protocol within a clerking proforma improve appropriate thromboprophylaxis in acute surgical admissions?

P
Population
111 acutely admitted surgical inpatients evaluated before and after the implementation of a VTE prevention protocol.
I
Intervention
VTE prevention protocol incorporating risk assessment and decision support within a new clerking proforma.
C
Comparator
Standard practice prior to protocol implementation (pilot audit).
O
Outcome
Proportion of subjects receiving appropriate VTE prophylaxis (enoxaparin and thromboembolic deterrent stockings) according to ACCP criteria.

Main Result

Absolute Event Rate: 88% vs 37%

p-value: p=<0.001

Implementing a VTE protocol within a surgical clerking proforma significantly improves the rate of appropriate thromboprophylaxis in acute surgical admissions.

Cite This Study

McKenna et al. (2008) studied Venous thromboembolism prevention (n=111). VTE prevention protocol within a clerking proforma vs. Usual care (pre-intervention audit) was evaluated on Appropriate VTE prophylaxis (p=<0.001). Implementation of a VTE protocol within a clerking proforma for acute surgical admissions increased appropriate VTE prophylaxis from 37% to 88% (p<0.001).

synapsesocial.com/papers/6a75c4e4dcfefe9676dd9424https://doi.org/10.1016/j.ijsu.2008.10.008
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Deep Vein Thrombosis Prophylaxis: Audit of Practice in General Surgical Patients in a Teaching Hospital2000 · 8 citations
  2. 2A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study1991 · 1,975 citations
  3. 3A Population-Based Perspective of the Hospital Incidence and Case-Fatality Rates of Deep Vein Thrombosis and Pulmonary Embolism1991 · 1,678 citations