[Prevention of thromboembolism in surgery--results of a survey in West German hospitals].
In 1990 a questionnaire on methods for prevention of deep venous thrombosis (DVT) and pulmonary embolism (LE) was mailed to 940 surgical centers in West Germany (FRG). The return rate was 60% or 564 answers, covering about 1,200,000 operations/year. The results are as follows: (1) Physical therapeutic measures (early mobilisation, elastic stockings) and drug administration are routinely used in all centers. The duration of prophylaxis is 3-8 days in 36% of centers, up to mobilisation in 31%, 9-16 days after operation in 17% and until demission in 16%. (2) A single drug regime is employed in 60% of centers (49% standard heparin, 9% low molecular heparin in combination with DHE) 40% of centers use all three drugs without clear cut guidelines concerning the indications. (3) The reported rates of thromboembolic complications diagnosed by clinical criteria are 0.55 +/- 0.62% for DVT and 0.22 +/- 0.29% for fatal or nonfatal LE. There is no evidence from the analysed data that the drug regimes influences the clinical outcome.


CONCLUSIONS
The need for administration of drugs prevent DVT is widely accepted. A polypragmatic approach seems to be effective. However, standardized regimes for defined clinical conditions are desirable.
Klempa
I
I
Klinik für Allgemein- und Gefässchirurgie, Zentralkrankenhaus St.-Jürgen-Strasse, Bremen.
Baca
I
I
Menzel
J
J
Rasche
H
H
D001458:Bandages; D003131:Combined Modality Therapy; D004087:Dihydroergotamine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004434:Early Ambulation; D006493:Heparin / Q000008:administration & dosage*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000517:prevention & control*; D013924:Thrombophlebitis / Q000517:prevention & control*
D004338:Drug Combinations; D006495:Heparin, Low-Molecular-Weight; C031388:heparin-dihydergot; D004087:Dihydroergotamine; D006493:Heparin
Thromboembolie-Prophylaxe in der Chirurgie--Ergebnis einer Umfrage an westdeutschen Krankenhäusern.