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Optimizing pharmacologic thromboprophylaxis use in pediatric orthopedic surgical patients through implementation of a

Wyatt MacNevin1, Kedar Padhye2, Yasser Alkhalife2

  • 1Division of Pediatric Hematology Oncology, Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada.

Pediatric Blood & Cancer
|November 21, 2020
PubMed

Insights

A new screening tool significantly reduced thromboprophylaxis use in pediatric orthopedic surgical patients by 47.9%. This approach lowered medication use without increasing venous thromboembolism or bleeding risks.

Area of Science:

  • Orthopedic Surgery
  • Hematology
  • Patient Safety

Background:

  • Venous thromboembolic events (VTE) pose a significant risk in pediatric orthopedic surgical patients (POSP).
  • A VTE thromboprophylaxis screening tool was developed and implemented in POSP since October 2016.

Purpose of the Study:

  • To evaluate the impact of a VTE thromboprophylaxis screening tool on its utilization in POSP.
  • To assess changes in VTE and bleeding complications post-implementation.

Main Methods:

  • Retrospective cohort study design.
  • POSP were screened and risk-stratified using the tool.
  • Spearman correlation analysis identified risk factors associated with thromboprophylaxis.

Main Results:

  • A 47.9% reduction in thromboprophylaxis use was observed post-implementation (P=0.046).
  • No VTE or significant bleeding complications occurred in either period.
  • Excellent compliance (100%) with the tool for high-risk patients.

Conclusions:

  • Successful implementation of a VTE thromboprophylaxis screening tool in POSP.
  • The tool significantly reduced thromboprophylaxis use without adverse events.
  • High-risk factors included BMI > 30, limited mobility, and complex/repeat surgeries.
Abstract

Keywords:
pediatric orthopedic surgeryprophylaxisscreening toolthrombosisvenous thromboembolism

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