Caprini JA, Arcelus JI, Hoffmann K, Mattern T, Laubach M,
Size GP, Traverso CI, Coats R.
Prevention of venous thromboembolism in North America: results of a survey among
general surgeons.
J Vasc Surg 1994 Nov;20(5):751-8

Department of Surgery, Glenbrook Hospital, IL 60025.

PURPOSE: The purpose of this study was to analyze current attitudes toward the
prevention of postoperative venous thromboembolism among North American general
surgeons. METHODS: A survey regarding awareness of the problem of venous
thromboembolism and preferred modalities of prophylaxis was sent to 3500 randomly
selected Fellows of the American College of Surgeons. RESULTS: A total of 1018
(29.1%) surveys was returned. Most of the responding surgeons consider venous
thromboembolism a serious health problem. Ninety percent of the surgeons use
prophylaxis against venous thromboembolism routinely. The most frequently used
modalities are intermittent pneumatic compression, low-dose heparin, and elastic
stocking. A combination of physical and pharmacologic methods is used by one
fourth of respondents, and only 50% start pharmacologic prophylaxis before the
surgical procedure. The thrombosis risk factors that are most frequently
considered by surgeons when deciding about using prophylaxis are history of
venous thromboembolism, immobility, and length of operation. CONCLUSIONS: North
American surgeons who responded to this survey are well aware of the problem of
venous thromboembolism and their approach to prevention has been significantly
modified in the last 10 years. Compared with similar European surveys this survey
reveals a higher implementations of physical methods such as intermittent
pneumatic compression and elastic stockings. Because of the limited response rate
and possibility of sampling bias, these findings should be interpreted with
caution.