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. 2011 Nov;118(5):978-986.
doi: 10.1097/AOG.0b013e31822c952a.

Quality of perioperative venous thromboembolism prophylaxis in gynecologic surgery

Jason D Wright  1 , Dawn L Hershman, Monjri Shah, William M Burke, Xuming Sun, Alfred I Neugut, Sharyn N Lewin, Thomas J Herzog
Affiliations

Quality of perioperative venous thromboembolism prophylaxis in gynecologic surgery

Jason D Wright et al. Obstet Gynecol. 2011 Nov.

Abstract

Objective: To estimate the use of venous thromboembolism prophylaxis in women undergoing gynecologic surgery and to estimate the patient, physician, and hospital characteristics associated with guideline-based prophylaxis.

Methods: A commercial database was used to examine women who underwent major gynecologic surgery from 2000 to 2010. Venous thromboembolism prophylaxis was classified as none, mechanical, pharmacologic, or a combination. Multivariable logistic regression models of factors associated with any prophylaxis and pharmacologic and combination prophylaxis were developed.

Results: We identified a total of 738,150 women who underwent gynecologic surgery. No prophylaxis was given to 292,034 (39.6%) women, whereas 344,068 (46.6%) received mechanical prophylaxis, 40,268 (5.5%) pharmacologic prophylaxis, and 61,780 (8.4%) combination prophylaxis. Use of prophylaxis increased from 53.5% in 2000 to 67.5% in 2010. Prophylaxis was more commonly used in older women, those with Medicare, women with more comorbidities, white women, patients treated at rural hospitals, teaching facilities, and in patients treated by high-volume surgeons and at high-volume centers (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.23-1.27, P<.05 for all). Factors associated with use of pharmacologic prophylaxis included advanced age, white race, noncommercial insurance, later year of diagnosis, greater comorbidity, treatment at large hospitals and urban facilities, and treatment by a high-volume surgeon (OR 1.47, 95% CI 1.44-1.49).

Conclusion: Despite clear recommendations from evidence-based guidelines, venous thromboembolism prophylaxis is underused in women undergoing gynecologic surgery.

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References

    1. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, et al.. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133:381S–453S.
    1. Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, et al.. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126:338S–400S.
    1. Prevention of deep vein thrombosis and pulmonary embolism. ACOG Practice Bulletin No. 84. American College of Obstetricians and Gynecologists. Obstet Gynecol 2007;110:429–40.
    1. Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell CW, Anderson FA Jr, et al.. Prevention of venous thromboembolism. Chest 2001;119:132S–75S.
    1. Maxwell GL, Synan I, Dodge R, Carroll B, Clarke-Pearson DL. Pneumatic compression versus low molecular weight heparin in gynecologic oncology surgery: a randomized trial. Obstet Gynecol 2001;98:989–95.

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