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Venous thromboembolism prophylaxis in thoracic surgery patients: an international survey

Title: Venous thromboembolism prophylaxis in thoracic surgery patients: an international survey
Authors: Shargall, Yaron; Brunelli, Alessandro; Murthy, Sudish; Schneider, Laura; Minervini, Fabrizio; Bertolaccini, Luca; Agzarian, John; Linkins, Lori-Ann; Kestenholz, Peter; Li, Hui; Rocco, Gaetano; Girard, Philippe; Venuta, Federico; Samama, Marc; Scarci, Marco; Anraku, Masaki; Falcoz, Pierre-Emmanuel; Kirk, Alan; Solli, Piergiorgio; Hofstetter, Wayne; Okumura, Meinoshin; Douketis, James; Litle, Virginia
Source: European Journal of Cardio-Thoracic Surgery ; ISSN 1010-7940 1873-734X
Publisher Information: Oxford University Press (OUP)
Publication Year: 2019
Description: 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.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ejcts/ezz191
DOI: 10.1093/ejcts/ezz191/29021203/ezz191.pdf
Availability: https://doi.org/10.1093/ejcts/ezz191; http://academic.oup.com/ejcts/advance-article-pdf/doi/10.1093/ejcts/ezz191/29021203/ezz191.pdf
Rights: https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model
Accession Number: edsbas.2DE21EF8
Database: BASE