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A Journal on Phlebology
Acta Phlebologica 2006 August;7(2):45-58
Venous thromboembolism in surgical patients, guidelines and evidence based medicine: efficacy evaluation
De Franciscis S. 1, Agus G. B. 2, Bisacci R. 3, Botta G. 4, Gasbarro V. 5, Domanin M. 6, Nobile C. G. A. 7, Serra R. 8
1 Unit of General Surgery, Head Research Local Unit University Magna Graecia of Catanzaro National Coordinator of the Research Project
2 Unit of Vascular Surgery Head Research Local Unit, University of Milan
3 Unit of Vascular Surgery Head Research Local Unit, University of Perugia
4 Unit of General Surgery Head Research Local Unit University of Siena
5 Unit of General Surgery Head Research Local Unit, University of Ferrara
6 Unit of Vascular Surgery Member Research Local Unit, University of Milan
7 Unit of Hygiene, Member Research Local Unit University Magna Graecia of Catanzaro
8 Unit of General Surgery, Member Research Local Unit University Magna Graecia of Catanzaro
Aim. Venous thromboembolism (VTE) is a major health problem. The aim of this study is to investigate the therapy plans used and to evaluate guidelines application for VTE, on which recent prophylaxis guidelines have developed, verifying their efficacy in a population of Clinical Centers of General Surgery, Gynaecology and Orthopaedics where this pathology is widely represented.
Methods. The authors conducted a retrospective analysis, related to National Relevant National Interest Research Projects support by Ministry of Research, recruiting 714 Clinical Departments of General Surgery, Gynaecology and Obstretics, Orthopaedics arranged in all the national territory. A questionnaire was sent to these Clinical Centers to state the available clinical and technical resources and to investigate the application of the guidelines for VTE.
Results. As a whole, 146 of the contacted centres have replied (20,4%): 48 Departments of General Surgery, 46 Departments of Gynaecology, 52 Departments of Orthopaedics. The answers showed adequate knowledge of the instrumental and laboratory diagnostic pathways for the suspect of VTE (80%). Data waiting were compared with morbidity and mortality rates related to DVT-PE showing an increase of mortality connected to the delay in diagnostic data timing of supply.
Conclusion. Surgical procedure and trauma are the focal moment of higher probability of developing a major event. A risk stratification and an adequate application of prophylaxis and treatment devices represent a real possibility to control morbidity and mortality. Diagnostic data waiting is a fundamental factor for an adequate prophylaxis.