THE DEVELOPMENT IN ATTITUDES TOWARDS THROMBOPROPHYLAXIS IN DANISH SURGICAL DEPARTMENTS DURING A 10-YEAR PERIOD

Objective: To summarize and evaluate the progress in the current pract ices of thromboprophylaxis (TP) in Danish surgical departments. Design : Summary of three questionnaire surveys in 1981, 1985 and 1990. Subje cts/Setting: Hospital departments performing general, orthopaedic or g ynaecological surgery in Denmark. Main outcome measures: Development o r routine employment of TP, standard instructions for TP, indications and methods for TP. Results: Replies were obtained from 85%-92%. Durin g 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 accordin g to standard instruc tions increased from 50% over 54% to 68% (p=0.00 1). Heparin is the drug of choice in 95% and graded compression stocki ngs in 70% of the departments. Only 36% of the departments routinely u se 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 litterature and international consensus conferences. However, the low rate of TP i n emergency surgery is unsatisfactory, and the use of acetylsalicylic acid as postoperative venous thromboprophylaxis should stop. The autho rs emphasize the introduction of firm standard instruction for TP in a ll surgical department. A continuous evaluation of the use of TP in Da nish surgical department by means of quality assurance studies is reco mmended.