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Variation in physician deep vein thrombosis prophylaxis attitudes and practices at an academic tertiary care center.
MedLine Citation:
PMID:  20174856     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Deep vein thrombosis (DVT) remains a major cause of in-hospital morbidity and mortality. Effective DVT prophylaxis is available but underutilized. We sought to describe physician understanding of DVT epidemiology and prophylaxis practices.
METHODS: All medical and surgical residents, and hospitalist attendings were invited to participate in an on-line survey. Physicians were queried about DVT epidemiology, risk factors, prophylaxis practices, and complications. Means and standard deviations were calculated for ordinal responses. χ² was used for dichotomous variables.
RESULTS: Of 281 doctors emailed, 69/160 (43%) medical residents, 26/72 (36%) surgical residents, and 21/49 (43%) hospitalist attendings participated. All three overestimated DVT incidence and morbidity. Surgical residents listed paralysis as high risk and minor surgery as a low/no risk factor. Medical residents thought heart failure and varicose veins were low/no risk for developing DVT. Regarding prophylaxis, surgical residents did not identify ambulation as a prophylactic measure, and were more likely to use SCDs, compression stockings, and enoxaparin, while medical residents and hospitalist attendings prescribed unfractionated heparin most frequently. Medical residents reported that they would hold anticoagulants for comorbidities most frequently, but all 3 groups agreed that anticoagulant prophylaxis would not significantly increase bleeding risks.
CONCLUSIONS: Perceptions of DVT risk factors and prophylaxis practices vary by both physician specialty and attending/resident status. Prophylaxis practice differences may result from these perceptions.
Authors:
Erin M Galbraith; Bonnie M Vautaw; Mary Grzybowski; Peter K Henke; Tomas W Wakefield; James B Froehlich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  30     ISSN:  1573-742X     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  419-25     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Emory University Hospitals, 1639 Pierce Drive, Suite 319 WMB, Atlanta, GA 30322, USA. Erin.M.Galbraith@gmail.com
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