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 to ward the prevention of postoperative venous thromboembolism among Nort h American general surgeons. Methods: A survey regarding awareness of the problem of venous thromboembolism and preferred modalities of prop hylaxis was sent to 3500 randomly selected Fellows of the American Col lege of Surgeons. Results: A total of 1018 (29.1%) surveys was returne d. Most of the responding surgeons consider venous thromboembolism a s erious health problem. Ninety percent of the surgeons use prophylaxis against venous thromboembolism routinely. The most frequently used mod alities 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 pharmacologi c prophylaxis before the surgical procedure. The thrombosis risk facto rs 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 resp onded to this survey are well aware of the problem of venous thromboem bolism and their approach to prevention has been significantly modifie d in the last 10 years. Compared with similar European surveys this su rvey reveals a higher implementation of physical methods such as inter mittent pneumatic compression and elastic stockings. Because of the li mited response rate and possibility of sampling bias, these findings s hould be interpreted with caution.