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Journal Article
Multicenter Study
The National Practice Patterns of Venous Thromboembolism Prophylaxis Post-Cardiothoracic Surgery.
Journal of Pharmacy Practice 2017 August
BACKGROUND: The rates of venous thromboembolism (VTE) post-cardiothoracic surgery are not well understood. The american college of chest physicians (CHEST) guidelines report weak recommendations for starting VTE prophylaxis post-cardiothoracic surgery. It is suspected that due to the increase in bleed risk, postsurgery initiation of pharmacologic VTE prophylaxis is limited.
OBJECTIVE: The study sought to investigate the use of VTE prevention in US hospitals performing cardiac surgery and the use of mechanical/chemical prophylaxis postoperatively.
METHODS: This is a multicenter survey distributed to cardiac hospitals in the United States. The survey was distributed through 3 separate listservs. Data were analyzed utilizing descriptive statistics.
RESULTS: The majority of the hospitals were academic and/or community and completed coronary artery bypass graft (CABG), valve replacement (mitral/aortic/tricuspid), and aortic repair. It was common for hospitals to start mechanical and pharmacologic prophylaxis post-cardiothoracic surgery on postoperative day (POD) 1 to 2. The anticoagulation most commonly used consisted of unfractionated heparin.
CONCLUSIONS: The majority of the institutions are initiating therapy POD 1 to 2 with both mechanical and chemical prophylaxis. The full impact of early initiation of VTE prophylaxis is unknown, and more studies are needed to assess the true risks/benefits of these practices.
OBJECTIVE: The study sought to investigate the use of VTE prevention in US hospitals performing cardiac surgery and the use of mechanical/chemical prophylaxis postoperatively.
METHODS: This is a multicenter survey distributed to cardiac hospitals in the United States. The survey was distributed through 3 separate listservs. Data were analyzed utilizing descriptive statistics.
RESULTS: The majority of the hospitals were academic and/or community and completed coronary artery bypass graft (CABG), valve replacement (mitral/aortic/tricuspid), and aortic repair. It was common for hospitals to start mechanical and pharmacologic prophylaxis post-cardiothoracic surgery on postoperative day (POD) 1 to 2. The anticoagulation most commonly used consisted of unfractionated heparin.
CONCLUSIONS: The majority of the institutions are initiating therapy POD 1 to 2 with both mechanical and chemical prophylaxis. The full impact of early initiation of VTE prophylaxis is unknown, and more studies are needed to assess the true risks/benefits of these practices.
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