Post-Surgery VTE Prophylaxis Use Varies Among Hospitals

Wide variation in venous thromboembolism prophylaxis use after spinal fusion surgery in U.S.

FRIDAY, July 15 (HealthDay News) -- The use of venous thromboembolism (VTE) prophylaxis after spinal fusion surgery varies widely in U.S. hospitals, according to a study published in the July issue of the Journal of Thrombosis and Haemostasis.

Margaret C. Fang, M.D., M.P.H., from the University of California San Francisco, and colleagues investigated the prevalence and outcomes of VTE use after spinal fusion surgery in 244 U.S. hospitals. The records of 80,183 patients from Premier Perspective database, who had undergone spinal fusion surgery between 2003 and 2005, were assessed for receipt of pharmacologic prophylaxis, mechanical prophylaxis, or both within the first seven days after surgery. Discharge diagnosis codes were also analyzed for VTE and postoperative hemorrhage during the period of hospitalization and within 30 days following surgery.

The investigators found that cervical and lumbar fusions were the most common surgeries conducted (49.0 and 47.8 percent, respectively). A total of 60.6 percent of the patients received thromboembolism prophylaxis within the first week after surgery, most frequently mechanical prophylaxis alone (47. 6 percent). Prophylaxis was provided to 90 percent or more of the patients in 26.2 percent of the hospitals, while 33. 2 percent of the hospitals provided prophylaxis to fewer than 50 percent of their patients. Venous thromboembolism was diagnosed within 30 days following surgery at a rate of 0.45 percent and the rate of postoperative hemorrhage was 1.1 percent.

"Substantial variation exists in the use of thromboembolism prophylaxis after spinal fusion surgery in the U.S.A. Nevertheless, overall rates of diagnosed thromboembolism after spinal fusion appear to be low," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical and health insurance industries.

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