Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25210
Title: Variations in practice of thromboprophylaxis across general surgical subspecialties: a multicentre (PROTECTinG) study of elective major surgeries.
Austin Authors: Liu, David Shi Hao ;Stevens, Sean;Wong, Enoch;Fong, Jonathan;Mori, Krinal;Fleming, Nicola ;Beh, Pith Soh ;Crowe, Amy;Howard, Tess;Slevin, Maeve;Jain, Anshini;Gill, Anna Sonia;Lee, Sharon;Jamel, Wael;Bennet, Simon;Chung, Chi;Ward, Salena;Muralidharan, Vijayaragavan 
Affiliation: Department of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia
Department of Surgery, Northern Health, Melbourne, Victoria, Australia
Department of Surgery, Box Hill Hospital, Melbourne, Victoria, Australia
Northern Precinct, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
Austin Precinct, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
Monash University Eastern Health Clinical School, Melbourne, Victoria, Australia
Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 30-Oct-2020
metadata.dc.date: 2020
Publication information: ANZ journal of surgery 2020; online first: 30 October
Abstract: Despite guidelines recommending perioperative thromboprophylaxis for patients undergoing general surgery, we have observed significant variations in its practice. This may compromise patient safety. Here, we quantify the heterogeneity of perioperative thromboprophylaxis across all major general surgical operations, and place them in relation to their risk of bleeding and venous thromboembolism. Retrospective review of all elective major general surgeries performed between 1 January 2018 and 30 June 2019 across seven Victorian hospitals was conducted. A total of 5912 patients who underwent 6628 procedures were reviewed. Significant heterogeneity was found in the use of chemoprophylaxis, timing of its initiation, type of anticoagulant administered and application of extended chemoprophylaxis. These variations were observed within the same procedure, and between different surgeries and subspecialties. Contrastingly, there was minimal heterogeneity with the use of mechanical thromboprophylaxis. Oesophago-gastric, liver and colorectal cancer resections had the highest thromboembolic risk. Breast, oesophago-gastric, liver, pancreas and colon cancer resections had the highest bleeding risk. Perioperative chemoprophylaxis across general surgery is highly variable. This study has highlighted key areas of variance. Our findings also enable surgeons to compare their practices, and provide baseline data to inform future efforts towards optimizing thromboprophylaxis for general surgical patients.
URI: https://ahro.austin.org.au/austinjspui/handle/1/25210
DOI: 10.1111/ans.16374
ORCID: 0000-0003-3522-1412
0000-0001-8936-4123
0000-0002-2983-4768
0000-0001-8247-8937
PubMed URL: 33124123
Type: Journal Article
Subjects: bleeding
general surgery
thromboembolism
thromboprophylaxis
Appears in Collections:Journal articles

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