Prophylaxis against thromboembolism in neurosurgical patients: a survey of current practice in the United Kingdom.
Venous thromboembolism is a life threatening, but preventable complication of major surgery. Many neurosurgical patients are at high risk of developing thromboembolic disease. A postal survey was undertaken of 44 UK neurosurgical centres to assess the use of physical and pharmacological methods of prophylaxis against thromboembolism. Thirty-five replies were received from 31 centres. Seventy-seven per cent of units used antiembolism stockings (TEDs) for elective surgery and 37% for emergency surgery; in approximately two-thirds of these units TEDs constituted the sole method of prophylaxis used during both elective and emergency surgery. Intermittent pneumatic compression (IPC) was utilized in 37 and 11% of units for elective and emergency surgery, respectively. Subcutaneous heparin was used in 32% of units perioperatively including 6% of emergency cases. These findings suggest that neurosurgical patients, who are at moderate to high risk of developing thromboembolic complications, may not receive effective prophylaxis; those undergoing emergency neurosurgery are less likely to receive any form of prophylaxis.
Stephens
P H
PH
Department of Anaesthetics, Royal London Hospital Trust, Whitechapel, UK.
Healy
M T
MT
Smith
M
M
Jewkes
D A
DA
D001921:Brain / Q000601:surgery*; D006306:Health Surveys; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D011183:Postoperative Complications; D011795:Surveys and Questionnaires; D013924:Thrombophlebitis / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D006113:United Kingdom
D006493:Heparin