爱尔兰骨科创伤中心骨科顾问对静脉血栓栓塞预防处方偏好的审计。

IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Charles Timon, Conor Kilkenny, Nicola Byrne, John F Quinlan, Niall P McGoldrick
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引用次数: 0

摘要

背景:血栓栓塞并发症在创伤骨科实践中很常见。尽管有广泛的研究,仍有一些悬而未决的问题,关于使用血栓预防。目的:建立目前的做法在爱尔兰咨询骨科医生关于血栓预防。方法:一份关于静脉血栓栓塞预防的保密在线问卷分发给爱尔兰共和国培训医院的所有骨科顾问医生。问题调查了外科医生对当地/国家指南的认识,住院和门诊处方偏好,以及同意/不同意防御医学,而不是循证医学,近年来在爱尔兰越来越重视静脉血栓栓塞预防。结果:有效率为72%(69/96)。72%(50/79)的外科医生了解当地静脉血栓栓塞预防指南。38%(29/96)的受访者了解国家指南。89%(62/69)常规使用机械预防方式。73.9%(51/69)的住院患者常规使用化学预防。然而,这种做法是极其异质与其他五种药物使用的其余。82.6%(57/69)的常规出院患者接受延长疗程的化学预防。67%(46/69)的人同意,最近越来越强调静脉血栓栓塞预防是由于防御性医学,而不是循证医学。结论:静脉血栓栓塞被认为是骨科手术的重要并发症,大多数骨科医生都积极预防。与之前对爱尔兰整形外科医生的调查相比,干预率更高,可能反映了外科医生对全国高诉讼率的担忧。然而,关于最佳治疗方法没有达成共识,这反映了在许多关于该主题的出版物中可获得的相互矛盾的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Audit of VTE prophylaxis prescribing preferences among orthopaedic consultants in Irish orthopaedic trauma centres.

Background: Thromboembolic complications are common in trauma orthopaedic practise. Despite extensive research, there remain a number of unanswered questions regarding the use of thromboprophylaxis.

Aims: To establish the current practise among Irish consultant orthopaedic surgeons regarding thromboprophylaxis.

Methods: A confidential online questionnaire regarding VTE prophylaxis was circulated to all consultant orthopaedic surgeons in training hospitals in the Republic of Ireland. Questions investigated surgeon awareness of local/national guidelines, inpatient and outpatient prescribing preferences and agreement/disagreement with the statement that defensive medicine, rather than evidence-based medicine, has driven increased emphasis on VTE prophylaxis in Ireland in recent years.

Results: The response rate was 72% (69/96). 72% (50/79) of surgeons were aware of local VTE prophylaxis guidelines. 38% (29/96) were aware of national guidelines. 89% (62/69) routinely used mechanical prophylaxis modalities. 73.9% (51/69) routinely used chemical prophylaxis for inpatients. However, this practise was z extremely heterogenous with five other pharmacological agents used by the remainder. 82.6% (57/69) routinely discharged patients on extended duration chemical prophylaxis. 67% (46/69) agreed that the recent increased emphasis on VTE prophylaxis was due to defensive medicine and not evidence-based medicine.

Conclusion: The results of this survey show that venous thromboembolism is regarded as a significant complication of orthopaedic surgery and most orthopaedic surgeons actively try to prevent it. There was a higher rate of intervention compared to previous surveys of Irish orthopaedic surgeons, possibly reflecting surgeon concerns regarding the high rate of litigation nationally. However, there is no consensus as to the optimum therapy which reflects the conflicting evidence available in the many publications on this subject.

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来源期刊
Irish Journal of Medical Science
Irish Journal of Medical Science 医学-医学:内科
CiteScore
3.70
自引率
4.80%
发文量
357
审稿时长
4-8 weeks
期刊介绍: The Irish Journal of Medical Science is the official organ of the Royal Academy of Medicine in Ireland. Established in 1832, this quarterly journal is a contribution to medical science and an ideal forum for the younger medical/scientific professional to enter world literature and an ideal launching platform now, as in the past, for many a young research worker. The primary role of both the Academy and IJMS is that of providing a forum for the exchange of scientific information and to promote academic discussion, so essential to scientific progress.
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