title: Venous thromboembolism prophylaxis for surgical patients in an Asian hospital.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is increasingly recognized as a significant postoperative complication in Asian hospitals. Recommendations have been published for VTE prophylaxis. We conducted a prospective survey of the risk profile and measures used for VTE prophylaxis in elective surgical patients in our hospital.
  
  
  METHODS
  All patients who underwent elective general or orthopaedic surgery over a 4-week period were included. Information collected included demographic data, presence of risk factors, type and duration of surgery, perioperative use of VTE prophylaxis and any diagnosis of deep vein thrombosis or pulmonary embolism during the current admission as well as in any readmissions in the 6 weeks after discharge. The patients were classified based on their age, risk factors and type of surgery into low, moderate, high or highest risk and the prophylactic measures they received compared with published recommendations.
  
  
  RESULTS
  Two hundred and twenty-six patients underwent 227 elective surgeries over the 4-week period. There were 7 low, 16 moderate, 45 high and 55 highest risk patients. One hundred and three patients could not be classified. Postoperative prophylactic measures were omitted in 93.8%, 81.8% and 31.5% of patients in moderate, high and highest risk groups, respectively. One patient developed clinical deep vein thrombosis preoperatively and one postoperatively. There were no cases of pulmonary embolism.
  
  
  CONCLUSIONS
  VTE prophylaxis is underutilized in our survey. Further studies are required to identify the reasons for omission and to develop hospital specific protocols to increase appropriate use of prophylaxis.
authors.affiliation: Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore, Republic of Singapore. li_hoon_tan@cgh.com.sg
authors.forename: Li Hoon
authors.initials: LH
authors.lastname: Tan
authors.forename: Shwu Chuin
authors.initials: SC
authors.lastname: Tan
mesh_terms: D000328:Adult; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012846:Singapore; D013923:Thromboembolism / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents