Profilaxis del tromboembolismo venoso en cirugía general en España. Análisis de una encuesta nacional / Prophylaxis of venous thromboembolism in general surgery in Spain. Analysis of a national survey

INTRODUCCIÓN: El tromboembolismo venoso (TEV) representa una complicación postoperatoria grave, pero evitable con una profilaxis adecuada. Las encuestas aportan información útil acerca de las actitudes y preferencias respecto a la prevención del TEV. MÉTODOS: Estudio transversal descriptivo, basado en una encuesta, remitida a los cirujanos generales miembros de la Asociación Española de Cirujanos (AEC), y que incluye 31 preguntas acerca del TEV postoperatorio y su prevención, así como 3 casos clínicos. RESULTADOS: La encuesta fue contestada por 530 cirujanos, lo que representa el 21,8% de los 2.429 miembros invitados a participar por correo electrónico. La mayoría de los cirujanos participantes trabajan en hospitales docentes grandes, siendo el 28,5% médicos residentes. Para el 28% el TEV representa un problema importante. Aunque el 81% considera que tiene un conocimiento adecuado sobre la prevención del TEV postoperatorio, un porcentaje similar reconoce necesitar más formación. La mayoría (98,7%) utiliza las heparinas de bajo peso molecular, consideradas la modalidad más eficaz y segura, seguida de los métodos mecánicos. El método de estratificación de riesgo más utilizado es el de Caprini (81%). La mayoría comienza la profilaxis farmacológica preoperatoriamente, pero existe bastante variación en las dosis utilizadas, así como en las pautas de inicio y duración, sobre todo en cirugía no oncológica. CONCLUSIONES: Existe interés y, en general, un adecuado conocimiento acerca de la prevención del TEV entre los cirujanos españoles. Sin embargo, creemos necesaria mayor formación sobre aspectos prácticos de la profilaxis, adaptando las recomendaciones de las guías recientes a protocolos locales

INTRODUCTION: Venous thromboembolism (VTE) represents a serious postoperative complication that can be prevented by adequate thromboprophylaxis. Surveys provide relevant information about clinician's attitudes and preferences regarding VTE prophylaxis. METHODS: Transversal, descriptive study based on a survey sent to general surgeons members of the Spanish Association of Surgeons (AEC), that included 31 questions regarding postoperative VTE and its prevention, as well as three clinical scenarios. RESULTS: 530 surgeons, 21.8% of the 2,429 invited by electronic mail to participate, completed the survey. Most of the answering clinicians work on in big teaching hospitals, and 28.5% are residents. VTE represents a serious problem for 28% of participants. Although 81% consider that their knowledge on the prevention of postoperative VTE is adequate, a similar percentage recognizes the need for further education. The vast majority (98.7%) use low molecular weight heparins, which are considered the most effective and safe modality, followed by mechanical methods. The Caprini risk assessment score is used by 81% of surgeons, who usually start pharmacological prophylaxis preoperatively. However, there are remarkable differences in the dosing of heparins, timing of initiation, and duration, especially in non-oncologic surgical patients. CONCLUSIONS: Most Spanish surgeons are interested in the prevention of postoperative VTE. Overall, the level of knowledge on thromboprophylaxis is adequate. However, our results indicate that there is a need for better education on relevant practical aspects of prophylaxis that could be achieved by incorporating recommendations from recent guidelines to local hospital-based protocols

Prophylaxis of venous thromboembolism in general surgery in Spain. Analysis of a national survey. / Profilaxis del tromboembolismo venoso en cirugía general en España. Análisis de una encuesta nacional.

INTRODUCTION: Venous thromboembolism (VTE) represents a serious postoperative complication that can be prevented by adequate thromboprophylaxis. Surveys provide relevant information about clinician's attitudes and preferences regarding VTE prophylaxis. METHODS: Transversal, descriptive study based on a survey sent to general surgeons members of the Spanish Association of Surgeons (AEC), that included 31 questions regarding postoperative VTE and its prevention, as well as three clinical scenarios. RESULTS: 530 surgeons, 21.8% of the 2,429 invited by electronic mail to participate, completed the survey. Most of the answering clinicians work on in big teaching hospitals, and 28.5% are residents. VTE represents a serious problem for 28% of participants. Although 81% consider that their knowledge on the prevention of postoperative VTE is adequate, a similar percentage recognizes the need for further education. The vast majority (98.7%) use low molecular weight heparins, which are considered the most effective and safe modality, followed by mechanical methods. The Caprini risk assessment score is used by 81% of surgeons, who usually start pharmacological prophylaxis preoperatively. However, there are remarkable differences in the dosing of heparins, timing of initiation, and duration, especially in non-oncologic surgical patients. CONCLUSIONS: Most Spanish surgeons are interested in the prevention of postoperative VTE. Overall, the level of knowledge on thromboprophylaxis is adequate. However, our results indicate that there is a need for better education on relevant practical aspects of prophylaxis that could be achieved by incorporating recommendations from recent guidelines to local hospital-based protocols.

Hemangioma de esófago cervical / Cervical esophageal hemangioma

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