PREVENTION OF VENOUS THROMBOEMBOLISM IN NORTH-AMERICA - RESULTS OF A SURVEY AMONG GENERAL SURGEONS

Purpose: The purpose of this study was to analyze current attitudes toward the prevention of postoperative venous thromboembolism among North American general surgeons. Methods: A survey regarding awareness of the problem of venous thromboembolism and preferred modalities of prophylaxis was sent to 3500 randomly selected Fellows of the American College of Surgeons. Results: A total of 1018 (29.1%) surveys was returned. Most of the responding surgeons consider venous thromboembolism a serious health problem. Ninety percent of the surgeons use prophylaxis against venous thromboembolism routinely. The most frequently used modalities are intermittent pneumatic compression, low-dose heparin, and elastic stockings. A combination of physical and pharmacologic methods is used by one fourth of respondents, and only 50% start pharmacologic prophylaxis before the surgical procedure. The thrombosis risk factors that are most frequently considered by surgeons when deciding about using prophylaxis are history of venous thromboembolism, immobility, and length of operation. Conclusions: North American surgeons who responded to this survey are well aware of the problem of venous thromboembolism and their approach to prevention has been significantly modified in the last 10 years. Compared with similar European surveys this survey reveals a higher implementation of physical methods such as intermittent pneumatic compression and elastic stockings. Because of the limited response rate and possibility of sampling bias, these findings should be interpreted with caution.