Graduate surgical trainee attitudes toward postoperative thromboprophylaxis.
BACKGROUND
Postoperative deep vein thrombosis (DVT) results in significant morbidity and mortality. Appropriate patient risk assessment and proper use of prophylactic measures is crucial.


METHODS
We conducted a confidential survey of general surgery house staff. The survey addressed DVT risk factor recognition, proximal and distal DVT absolute risk estimation, DVT prophylaxis strategies, and vena cava filter and low-molecular-weight heparin (LMWH) use.


RESULTS
Obesity, immobility, malignancy, and previous DVT were overwhelmingly recognized as risk factors. Age >40, recent myocardial infarction, lupus anticoagulant, varicose veins, and factor V Leiden were inadequately recognized as risks. Deep vein thrombosis risk in the setting of cancer was underestimated. Most selected appropriate prophylactic strategies; many misunderstood vena cava filter and LMWH indications.


CONCLUSIONS
We have identified specific areas of misunderstanding about DVT risk and prophylaxis that, if appropriately addressed during educational sessions, will enable young surgeons to make safer and more effective future decisions regarding thromboprophylaxis.
Kimmerly
W S
WS
Department of Medicine, College of Medicine, University of Tennessee, Memphis, USA.
Sellers
K D
KD
Deitcher
S R
SR
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D005260:Female; D013502:General Surgery / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013714:Tennessee; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight