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The Perception of Evidence for Venous Thromboembolism Prophylaxis Current Practices after Cardiac Surgery: A Canadian Cross-Sectional Survey.

Mufti HN, Baskett RJ, Arora RC, Légaré JF - Thrombosis (2015)

Bottom Line: Results.Conclusions.Our findings highlight the need for appropriately designed studies to fill this knowledge gap.

View Article: PubMed Central - PubMed

Affiliation: 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.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus

Assesment of participants knowledge and perception of the prevelance VTE after cardiac surgery and the evidance of its prophlaxis. (a) Perception of the incidence of DVT after cardiac surgery. (b) Perception of the incidence of PE after cardiac surgery. (c) Perception of the class of the recommendation of VTE prophylaxis after cardiac surgery (class I: benefit greatly exceeds the risk and treatment should be administered (is effective), class IIa: benefit exceeds the risk and it is reasonable to administer treatment (most likely effective), and class IIb: benefit probably exceeds the risk and treatment may be considered (efficacy less well established)). (d) Perception of the level of evidence of VTE prophylaxis after cardiac surgery (level A: evidence from multiple randomized trials or meta-analysis, level B: limited evidence from a single randomized trial or nonrandomized studies with some conflicting evidence of benefit, and level C: expert opinions or case reports).
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Related In: Results  -  Collection


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fig4: Assesment of participants knowledge and perception of the prevelance VTE after cardiac surgery and the evidance of its prophlaxis. (a) Perception of the incidence of DVT after cardiac surgery. (b) Perception of the incidence of PE after cardiac surgery. (c) Perception of the class of the recommendation of VTE prophylaxis after cardiac surgery (class I: benefit greatly exceeds the risk and treatment should be administered (is effective), class IIa: benefit exceeds the risk and it is reasonable to administer treatment (most likely effective), and class IIb: benefit probably exceeds the risk and treatment may be considered (efficacy less well established)). (d) Perception of the level of evidence of VTE prophylaxis after cardiac surgery (level A: evidence from multiple randomized trials or meta-analysis, level B: limited evidence from a single randomized trial or nonrandomized studies with some conflicting evidence of benefit, and level C: expert opinions or case reports).

Mentions: With regard to respondents' knowledge on the quality of evidence of VTE prophylaxis in cardiac surgery, 60% believed that the class of recommendation was high (class I and class IIa) but thought that the level of evidence was low (level B or level C). The majority of the respondents believed that the incidence of postoperative above knee DVT in cardiac surgery patients is between 1 and 5% (47%) and the incidence of postoperative pulmonary embolism is less than 1% (62.5%) (Figure 4).


The Perception of Evidence for Venous Thromboembolism Prophylaxis Current Practices after Cardiac Surgery: A Canadian Cross-Sectional Survey.

Mufti HN, Baskett RJ, Arora RC, Légaré JF - Thrombosis (2015)

Assesment of participants knowledge and perception of the prevelance VTE after cardiac surgery and the evidance of its prophlaxis. (a) Perception of the incidence of DVT after cardiac surgery. (b) Perception of the incidence of PE after cardiac surgery. (c) Perception of the class of the recommendation of VTE prophylaxis after cardiac surgery (class I: benefit greatly exceeds the risk and treatment should be administered (is effective), class IIa: benefit exceeds the risk and it is reasonable to administer treatment (most likely effective), and class IIb: benefit probably exceeds the risk and treatment may be considered (efficacy less well established)). (d) Perception of the level of evidence of VTE prophylaxis after cardiac surgery (level A: evidence from multiple randomized trials or meta-analysis, level B: limited evidence from a single randomized trial or nonrandomized studies with some conflicting evidence of benefit, and level C: expert opinions or case reports).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4644839&req=5

fig4: Assesment of participants knowledge and perception of the prevelance VTE after cardiac surgery and the evidance of its prophlaxis. (a) Perception of the incidence of DVT after cardiac surgery. (b) Perception of the incidence of PE after cardiac surgery. (c) Perception of the class of the recommendation of VTE prophylaxis after cardiac surgery (class I: benefit greatly exceeds the risk and treatment should be administered (is effective), class IIa: benefit exceeds the risk and it is reasonable to administer treatment (most likely effective), and class IIb: benefit probably exceeds the risk and treatment may be considered (efficacy less well established)). (d) Perception of the level of evidence of VTE prophylaxis after cardiac surgery (level A: evidence from multiple randomized trials or meta-analysis, level B: limited evidence from a single randomized trial or nonrandomized studies with some conflicting evidence of benefit, and level C: expert opinions or case reports).
Mentions: With regard to respondents' knowledge on the quality of evidence of VTE prophylaxis in cardiac surgery, 60% believed that the class of recommendation was high (class I and class IIa) but thought that the level of evidence was low (level B or level C). The majority of the respondents believed that the incidence of postoperative above knee DVT in cardiac surgery patients is between 1 and 5% (47%) and the incidence of postoperative pulmonary embolism is less than 1% (62.5%) (Figure 4).

Bottom Line: Results.Conclusions.Our findings highlight the need for appropriately designed studies to fill this knowledge gap.

View Article: PubMed Central - PubMed

Affiliation: 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.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus