Faculty Collaboration Database

Optimizing pharmacologic thromboprophylaxis use in pediatric orthopedic surgical patients through implementation of a perioperative venous thromboembolism risk screening tool. Pediatr Blood Cancer 2021 Feb;68(2):e28803

Date

11/22/2020

Pubmed ID

33219749

DOI

10.1002/pbc.28803

Scopus ID

2-s2.0-85096644082 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

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.

Author List

MacNevin W, Padhye K, Alkhalife Y, Price V, El-Hawary R, Branchford BR, Stevens S, Kulkarni K

Author

Brian Branchford MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Female
Humans
Male
Mass Screening
Orthopedic Procedures
Perioperative Period
Pulmonary Embolism
Retrospective Studies
Risk Factors
Venous Thromboembolism
Venous Thrombosis