The development in attitudes towards thromboprophylaxis in Danish surgical departments during a ten year period.

OBJECTIVE

To summarize and evaluate the progress in the current practices of thromboprophylaxis (TP) in Danish surgical departments.

DESIGN

Summary of three questionnaire surveys in 1981, 1985 and 1990.

SUBJECTS/SETTING: Hospital departments performing general, orthopaedic or gynaecological surgery in Denmark.

MAIN OUTCOME MEASURES

Development or routine employment of TP, standard instructions for TP, indications and methods for TP.

RESULTS

Replies were obtained from 85%-92%. During the period the overall use TP increased from 89% of the departments in 1981 to 93% in 1985 to 96% in 1990 (p = 0.03). The use of TP according to standard instructions increased from 50% over 54% to 68% (p = 0.001). Heparin is the drug of choice in 95% and graded compression stockings in 70% of the departments. Only 36% of the departments routinely use TP in emergency surgery.

CONCLUSIONS

The development in attitudes towards TP in Denmark complies with the scientific evolution. Methods and indications correspond with the recommendation of the literature and international consensus conferences. However, the low rate of TP in emergency surgery is unsatisfactory, and the use of acetylsalicylic acid as postoperative venous thromboprophylaxis should stop. The authors emphasize the introduction of firm standard instruction for TP in all surgical department. A continuous evaluation of the use of TP in Danish surgical department by means of quality assurance studies is recommended.