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Graduate surgical trainee attitudes toward postoperative thromboprophylaxis
W S Kimmerly1, K D Sellers, S R Deitcher
1Department of Medicine, College of Medicine, University of Tennessee, Memphis, USA.
Background:
Postoperative deep vein thrombosis (DVT) results in significant morbidity and mortality. Appropriate patient risk assessment and proper use of prophylactic measures is crucial.
Methods:
We conducted a confidential survey of general surgery house staff. The survey addressed DVT risk factor recognition, proximal and distal DVT absolute risk estimation, DVT prophylaxis strategies, and vena cava filter and low-molecular-weight heparin (LMWH) use.
Results:
Obesity, immobility, malignancy, and previous DVT were overwhelmingly recognized as risk factors. Age >40, recent myocardial infarction, lupus anticoagulant, varicose veins, and factor V Leiden were inadequately recognized as risks. Deep vein thrombosis risk in the setting of cancer was underestimated. Most selected appropriate prophylactic strategies; many misunderstood vena cava filter and LMWH indications.
Conclusions:
We have identified specific areas of misunderstanding about DVT risk and prophylaxis that, if appropriately addressed during educational sessions, will enable young surgeons to make safer and more effective future decisions regarding thromboprophylaxis.