Variation in physician deep vein thrombosis prophylaxis attitudes and practices at an academic tertiary care center.
BACKGROUND
Deep vein thrombosis (DVT) remains a major cause of in-hospital morbidity and mortality. Effective DVT prophylaxis is available but underutilized. We sought to describe physician understanding of DVT epidemiology and prophylaxis practices.


METHODS
All medical and surgical residents, and hospitalist attendings were invited to participate in an on-line survey. Physicians were queried about DVT epidemiology, risk factors, prophylaxis practices, and complications. Means and standard deviations were calculated for ordinal responses. χ² was used for dichotomous variables.


RESULTS
Of 281 doctors emailed, 69/160 (43%) medical residents, 26/72 (36%) surgical residents, and 21/49 (43%) hospitalist attendings participated. All three overestimated DVT incidence and morbidity. Surgical residents listed paralysis as high risk and minor surgery as a low/no risk factor. Medical residents thought heart failure and varicose veins were low/no risk for developing DVT. Regarding prophylaxis, surgical residents did not identify ambulation as a prophylactic measure, and were more likely to use SCDs, compression stockings, and enoxaparin, while medical residents and hospitalist attendings prescribed unfractionated heparin most frequently. Medical residents reported that they would hold anticoagulants for comorbidities most frequently, but all 3 groups agreed that anticoagulant prophylaxis would not significantly increase bleeding risks.


CONCLUSIONS
Perceptions of DVT risk factors and prophylaxis practices vary by both physician specialty and attending/resident status. Prophylaxis practice differences may result from these perceptions.
Galbraith
Erin M
EM
Division of Cardiology, Emory University Hospitals, 1639 Pierce Drive, Suite 319 WMB, Atlanta, GA 30322, USA. Erin.M.Galbraith@gmail.com
Vautaw
Bonnie M
BM
Grzybowski
Mary
M
Henke
Peter K
PK
Wakefield
Tomas W
TW
Froehlich
James B
JB
D000293:Adolescent; D000925:Anticoagulants / Q000008:administration & dosage; D001291:Attitude of Health Personnel; D001930:Brain Injuries / Q000175:diagnosis / Q000628:therapy; D020445:Hospitalists; D006801:Humans; D007396:Internship and Residency; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000628:therapy; D010819:Physician's Role / Q000523:psychology; D011795:Surveys and Questionnaires; D020246:Venous Thrombosis / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D055815:Young Adult
D000925:Anticoagulants