Inappropriate Venous Thromboembolism Prophylaxis in a General Surgery Department: Risk Factors and Improvement with a Simple Educational Program

2020 
The aim of this study was to describe the rate of patients with an inappropriate venous thromboembolism (VTE) prophylaxis in a Department of Surgery, study the risk factors associated with an inappropriate VTE prophylaxis, and analyze the effect of a simple educational program to improve these results. A quasi-experimental study was performed. VTE prophylaxis was studied in a Department of Surgery. The results of this analysis were presented to the Staff of the Department. Then, prophylaxis was again studied to analyze if this simple educational program improved these results. Inappropriate prophylaxis was seen in nearly 40% of the patients, mainly due to a lack of prescription. Inappropriate prophylaxis was associated with advanced age, ASA, surgical patient, no same-day surgery, no discharged patients, and high VTE risk. In the multivariate analysis, only no same-day surgery was related to inappropriate prophylaxis. The educational program achieved a non-significant reduction of inappropriate prophylaxis (31.7% vs. 40.5%, p = 0.070). A high percentage of patients in the Department of Surgery had an inappropriate VTE prophylaxis, mainly due to the lack of prescription. A simple educational program improved VTE prophylaxis prescription, although this improvement was not statistically significant.
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