The Perception of Evidence for Venous Thromboembolism Prophylaxis Current Practices after Cardiac Surgery: A Canadian Cross-Sectional Survey

Abstract

Background. Venous thromboembolism (VTE) is the third leading cause of cardiovascular death in patients undergoing surgery. However, VTE prophylaxis practices in cardiac surgery are based on noncardiac surgical literature. The objective of our study was to extract current patterns of VTE prophylaxis practices in cardiac surgery patients. We also aimed to identify health care professionals knowledge of available evidence supporting VTE prophylaxis in adult cardiac surgery patients. Methods. A web-based survey was developed and sent to all Canadian cardiac surgery centers with the intent to have the survey distributed to all personnel involved in the perioperative care of adult cardiac surgery patients. Participation in the questionnaire was voluntary and anonymized. Results. Thirty-five responses were obtained. Sixty-nine percent reported having an established protocol for VTE prophylaxis. However, 83% reported using VTE prophylaxis in their daily practice despite lack of protocol. The majority (60%) believed that the class of recommendation was high despite the lack of evidence. Conclusions. Our survey demonstrated the following. (a) Majority of Canadian centers employ VTE prophylaxis, with considerable variability. (b) There is a misconception among health care professionals about the strength of evidence supporting VTE prophylaxis in cardiac surgery. Our findings highlight the need for appropriately designed studies to fill this knowledge gap.