TY - JOUR
T1 - Venous thromboembolism prophylaxis in thoracic surgery patients
T2 - An international survey
AU - Shargall, Yaron
AU - Brunelli, Alessandro
AU - Murthy, Sudish
AU - Schneider, Laura
AU - Minervini, Fabrizio
AU - Bertolaccini, Luca
AU - Agzarian, John
AU - Linkins, Lori Ann
AU - Kestenholz, Peter
AU - Li, Hui
AU - Rocco, Gaetano
AU - Girard, Philippe
AU - Venuta, Federico
AU - Samama, Marc
AU - Scarci, Marco
AU - Anraku, Masaki
AU - Falcoz, Pierre Emmanuel
AU - Kirk, Alan
AU - Solli, Piergiorgio
AU - Hofstetter, Wayne
AU - Okumura, Meinoshin
AU - Douketis, James
AU - Litle, Virginia
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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.
AB - 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.
KW - Guidelines
KW - International
KW - Prophylaxis
KW - Survey
KW - Thoracic surgery
KW - Venous thromboembolism
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U2 - 10.1093/ejcts/ezz191
DO - 10.1093/ejcts/ezz191
M3 - Article
C2 - 31363740
AN - SCOPUS:85077945203
SN - 1010-7940
VL - 57
SP - 331
EP - 337
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 2
ER -