Prophylaxis for deep venous thrombosis: Knowledge and practice of surgeons

Objective: Despite high incidence (10%-80%) for venous thromboembolism (VTE) after surgery, many report show suboptimal risk assessment and inadequate prophylactic measure for this condition. The aim of this study was to determine knowledge, attitude and practice of surgeons about deep venous thromboembolism (DVT) prophylaxis.

Methodology: The knowledge and attitude of faculty member surgeons working in Kermanshah University of Medical Sciences were evaluated using a questionnaire. In addition, their practice was assessed by reviewing the hospital chart of 4105 patients who had elective or emergency surgery. Patients were categorized based on claget criteria into high, moderate and low risk for DVT.

Results: Mean knowledge score was 9.05�1.07 (82.3% of best predicted) and for attitude was 21.9�2.78 (73.1% of best predicted). There were no statistical significant differences between surgical clinical groups. Nearly all of surgeons believed that use of low dose heparin was dangerous. Type of prophylactic measure was only low dose heparin. Only 9 (3.2%) patients from high risk group and 9 (1.08%) patients from moderate risk group received prophylactic treatment and no one from low risk group for DVT received prophylaxis.

Conclusions: Degree of under use of prophylactic measure for DVT is higher in this study as to compare with other investigations. Increased awareness about optimal prevention and outcomes is needed. It is highly recommended that all patients undergoing surgery must be routinely assess for preoperative risk for DVT and consider aggressive prophylactic measure against this condition.