Mufti Hani N, Baskett Roger J F, Arora Rakesh C, Légaré Jean-Francois
Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Center, 1796 Summer Street, Room 2269, Halifax, NS, Canada B3H 3A7.
St. Boniface Hospital, I.H. Asper Clinical Research Institute, University of Manitoba, CR3012-369 Tache Avenue, Winnipeg, MB, Canada R2H 2A6.
Thrombosis. 2015;2015:795645. doi: 10.1155/2015/795645. Epub 2015 Nov 2.
Background. Venous thromboembolism (VTE) is the third leading cause of cardiovascular death in patients undergoing surgery. However, VTE prophylaxis practices in cardiac surgery are based on noncardiac surgical literature. The objective of our study was to extract current patterns of VTE prophylaxis practices in cardiac surgery patients. We also aimed to identify health care professionals knowledge of available evidence supporting VTE prophylaxis in adult cardiac surgery patients. Methods. A web-based survey was developed and sent to all Canadian cardiac surgery centers with the intent to have the survey distributed to all personnel involved in the perioperative care of adult cardiac surgery patients. Participation in the questionnaire was voluntary and anonymized. Results. Thirty-five responses were obtained. Sixty-nine percent reported having an established protocol for VTE prophylaxis. However, 83% reported using VTE prophylaxis in their daily practice despite lack of protocol. The majority (60%) believed that the class of recommendation was high despite the lack of evidence. Conclusions. Our survey demonstrated the following. (a) Majority of Canadian centers employ VTE prophylaxis, with considerable variability. (b) There is a misconception among health care professionals about the strength of evidence supporting VTE prophylaxis in cardiac surgery. Our findings highlight the need for appropriately designed studies to fill this knowledge gap.
背景。静脉血栓栓塞症(VTE)是接受手术患者心血管死亡的第三大主要原因。然而,心脏手术中的VTE预防措施是基于非心脏手术的文献。我们研究的目的是提取心脏手术患者当前的VTE预防措施模式。我们还旨在确定医疗保健专业人员对支持成人心脏手术患者VTE预防的现有证据的了解情况。方法。开展了一项基于网络的调查,并发送给所有加拿大心脏手术中心,目的是将该调查分发给参与成人心脏手术患者围手术期护理的所有人员。参与问卷调查是自愿且匿名的。结果。获得了35份回复。69%的回复称有既定的VTE预防方案。然而,83%的回复称尽管没有方案,但在日常实践中仍使用VTE预防措施。大多数人(60%)认为尽管缺乏证据,但推荐等级很高。结论。我们的调查表明了以下几点。(a)大多数加拿大中心采用VTE预防措施,但存在很大差异。(b)医疗保健专业人员对支持心脏手术中VTE预防的证据强度存在误解。我们的研究结果凸显了开展适当设计的研究以填补这一知识空白的必要性。