{"title":"Promotion of a venous thromboembolism prevention protocol at a perioperative management center.","authors":"Himuro Fujiwara, Chizuru Yamashita, Takahiro Kawaji, Tomoyuki Nakamura, Naohide Kuriyama, Yoshitaka Hara, Satoshi Komatsu, Minako Fukushima, Shinya Suzuki, Takaaki Tsutsumi, Osamu Nishida","doi":"10.20407/fmj.2022-024","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Perioperative venous thromboembolism (VTE) is a potentially fatal complication, making preoperative VTE diagnosis and secondary thromboprophylaxis important. This study was performed to investigate the impact of promotion of a preoperative VTE protocol at a perioperative management center (PMC) on detecting the preoperative VTE rate and subsequent treatment.</p><p><strong>Methods: </strong>This retrospective study involved patients aged ≥20 years who underwent elective anesthesia. The patients were divided into two groups: the pre-PMC group (January to October 2014, before the opening of the PMC) and the post-PMC group (January to December 2019, after the opening of the PMC). The rates of preoperative lower-limb compression ultrasonography (CUS), VTE detection, anticoagulation therapy, and new postoperative pulmonary embolism (PE) were compared between the two groups.</p><p><strong>Results: </strong>The pre-PMC and post-PMC groups comprised 3737 and 5388 patients, respectively. The preoperative CUS and VTE detection rates were significantly higher in the post-PMC than pre-PMC group (7.2% and 1.43% vs. 25.6% and 3.93%, respectively; P<0.001). There was no significant difference in the rate of anticoagulation therapy in patients with preoperative VTE (88.9% vs. 84.7%, P=0.43). Heparin and direct oral anticoagulants were primarily used in the pre-PMC and post-PMC groups, respectively. The efficacy and safety were comparable between the two groups. No new postoperative PE was detected in either group.</p><p><strong>Conclusions: </strong>Promotion of the preoperative VTE protocol led by the PMC increased the rates of preoperative CUS and preoperative VTE detection. This may aid in secondary thromboprophylaxis in the preoperative period and prevention of postoperative PE.</p>","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"9 3","pages":"179-185"},"PeriodicalIF":0.0000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405905/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Fujita Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.20407/fmj.2022-024","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Perioperative venous thromboembolism (VTE) is a potentially fatal complication, making preoperative VTE diagnosis and secondary thromboprophylaxis important. This study was performed to investigate the impact of promotion of a preoperative VTE protocol at a perioperative management center (PMC) on detecting the preoperative VTE rate and subsequent treatment.
Methods: This retrospective study involved patients aged ≥20 years who underwent elective anesthesia. The patients were divided into two groups: the pre-PMC group (January to October 2014, before the opening of the PMC) and the post-PMC group (January to December 2019, after the opening of the PMC). The rates of preoperative lower-limb compression ultrasonography (CUS), VTE detection, anticoagulation therapy, and new postoperative pulmonary embolism (PE) were compared between the two groups.
Results: The pre-PMC and post-PMC groups comprised 3737 and 5388 patients, respectively. The preoperative CUS and VTE detection rates were significantly higher in the post-PMC than pre-PMC group (7.2% and 1.43% vs. 25.6% and 3.93%, respectively; P<0.001). There was no significant difference in the rate of anticoagulation therapy in patients with preoperative VTE (88.9% vs. 84.7%, P=0.43). Heparin and direct oral anticoagulants were primarily used in the pre-PMC and post-PMC groups, respectively. The efficacy and safety were comparable between the two groups. No new postoperative PE was detected in either group.
Conclusions: Promotion of the preoperative VTE protocol led by the PMC increased the rates of preoperative CUS and preoperative VTE detection. This may aid in secondary thromboprophylaxis in the preoperative period and prevention of postoperative PE.
目的:围手术期静脉血栓栓塞(VTE)是一种潜在的致命并发症,术前VTE诊断和继发性血栓预防非常重要。本研究旨在探讨围手术期管理中心(PMC)推广术前VTE方案对术前VTE率检测和后续治疗的影响。方法:本回顾性研究纳入年龄≥20岁的择期麻醉患者。患者分为两组:PMC前组(2014年1月至10月,PMC开业前)和PMC后组(2019年1月至12月,PMC开业后)。比较两组患者术前下肢压缩超声(CUS)、静脉血栓栓塞(VTE)检出率、抗凝治疗及术后新发肺栓塞(PE)发生率。结果:pmc前组和pmc后组分别有3737例和5388例患者。pmc组术前CUS和VTE检出率显著高于pmc前组(分别为7.2%和1.43% vs. 25.6%和3.93%;结论:以PMC为主导的VTE术前方案的推广提高了术前CUS和VTE检出率。这可能有助于术前的继发性血栓预防和术后PE的预防。