Factors associated with inappropriate chemical prophylaxis of thromboembolism in surgical patients

Introduction: Despite various guidelines for venous thromboembolism (VTE) prevention, malpractice in prescribing thromboprophylaxis is common. In this study, factors associated with prescribing or not prescribing appropriate chemical thromboprophylaxis were assessed.

Materials and methods: We enrolled high-risk patients for VTE (based on Caprini score) in the general surgery ward. They were divided into 2 groups based on receiving appropriate prophylaxis or not. Factors associated with prescribing thromboprophylaxis were analyzed.

Results: A total of 613 patients were enrolled in this study. Head and neck operations (P < .0001), minor surgeries (P = .001), mastectomy (P = .012), and medical treatment (P = 0.034) were the factors associated with not prescribing thromboprophylaxis. In contrast, age (P < .0001), laparoscopic surgeries (P = .011), surgery duration (< .0001), oral contraceptive pill consumption (P = .005), and complete bed rest (P = .002) were protective factors.

Conclusion: Minor surgeries, head and neck operations, mastectomy, and medical treatment are associated with overlooking anticoagulant administration. It is recommended to consider aforementioned pitfalls in routine practice and education.