Optimizing pharmacologic thromboprophylaxis use in pediatric orthopedic surgical patients through implementation of a perioperative venous thromboembolism risk screening tool

Wyatt MacNevin, Kedar Padhye, Yasser Alkhalife, Victoria Price, Ron El-Hawary, Brian R. Branchford, Sarah Stevens, Ketan Kulkarni

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

5 Citas (Scopus)

Resumen

Background: Although rare, venous thromboembolic events (VTE) are a significant challenge in pediatric orthopedic surgical patients (POSP). A VTE thromboprophylaxis screening tool was developed and implemented in POSPs at the IWK Health Centre since October 2016. Objectives: This retrospective cohort study was designed to evaluate and assess the impact of the VTE thromboprophylaxis screening tool in terms of use of thromboprophylaxis in POSP. Methods: Using the tool, POSPs were screened and were categorized into risk groups. Patient groups were compared and spearman correlation analysis was performed to show the strength of association between risk factors and thromboprophylaxis. Retrospective screening of pre-algorithm patients who received thromboprophylaxis was done to further assess the screening tool. Results: After the implementation of the VTE thromboprophylaxis screening tool in POSPs, there was a 47.9% reduction in the use of thromboprophylaxis (P = 0.046) as compared with before. Neither VTE nor significant bleeding complications occurred before or after screening tool implementation. Compliance with the screening tool was excellent (100% of patients in the high-risk category received thromboprophylaxis). High-risk patients were more likely to have body mass index > 30 (35.7%), limited/altered mobility (57.1%), and to be undergoing a complicated/repeat surgery (64.3%). Conclusions: The present study demonstrates successful implementation of a VTE thromboprophylaxis screening tool that resulted in significant reduction in use of thromboprophylaxis in POSPs with no increase in VTE or change in bleeding complications.

Idioma originalEnglish
Número de artículoe28803
PublicaciónPediatric Blood and Cancer
Volumen68
N.º2
DOI
EstadoPublished - feb. 2021
Publicado de forma externa

Nota bibliográfica

Publisher Copyright:
© 2020 Wiley Periodicals LLC

ASJC Scopus Subject Areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

PubMed: MeSH publication types

  • Journal Article

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