title: A survey of current practice of venous thromboembolism prophylaxis in hospitalized inflammatory bowel disease patients in the United States.
abstract: BACKGROUND
  Inflammatory bowel disease (IBD) patients are at an increased risk of thrombosis, particularly when hospitalized. Several clinical practice guidelines now recommend pharmacologic prophylaxis for hospitalized ulcerative colitis and Crohn's disease patients. It is unclear to what extent gastroenterologists are aware of these recommendations and whether they are administering pharmacologic venous thromboembolism (VTE) prophylaxis appropriately. Our aim was to explore current practice of VTE prophylaxis in hospitalized IBD patients in the United States.
  
  
  METHODS
  A survey was mailed electronically to gastroenterologists whose electronic mail address was listed in the American College of Gastroenterology (ACG) database. This survey included clinical vignettes outlining scenarios for consideration of VTE prophylaxis.
  
  
  RESULTS
  A total of 6227 surveys were sent to gastroenterologists nationwide, and 591 physicians chose to participate (response rate 9.5%). Respondents (80.6%) believed that hospitalized IBD patients have a higher risk of VTE than other inpatients. A total of 29.1% were unaware of any recommendations addressing pharmacologic prophylaxis included in ACG IBD guidelines and 34.6% would give pharmacologic VTE prophylaxis to a hospitalized patient with severe ulcerative colitis. Heparin VTE prophylaxis use was associated with gastroenterologists who indicated that their practices comprised more than 50% of patients with IBD (P=0.0001), being a physician at an academic hospital (P=0.0001) and providers having less than 5 years practice experience (P=0.003).
  
  
  CONCLUSIONS
  Despite reasonable awareness of the increased risk of thrombosis in hospitalized IBD patients, many US gastroenterologists may not follow clinical practice guidelines and use pharmacologic VTE prophylaxis.
authors.affiliation: Dr Henry D. Janowitz Division of Gastroenterology, Mount Sinai School of Medicine, New York, NY 10029, USA. andrew.tinsley@mountsinai.org
authors.forename: Andrew
authors.initials: A
authors.lastname: Tinsley
authors.forename: Steven
authors.initials: S
authors.lastname: Naymagon
authors.forename: Arvind J
authors.initials: AJ
authors.lastname: Trindade
authors.forename: David B
authors.initials: DB
authors.lastname: Sachar
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Sands
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Ullman
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D005762:Gastroenterology; D019538:Health Care Surveys; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D007297:Inpatients; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D000078329:Workforce
chemical_list: D000925:Anticoagulants; D006493:Heparin