Premium
Reduction in deep vein thrombosis incidence in intensive care after a clinician education program
Author(s) -
BODDI M.,
BARBANI F.,
ABBATE R.,
BONIZZOLI M.,
BATACCHI S.,
LUCENTE E.,
CHIOSTRI M.,
GENSINI G. F.,
PERIS A.
Publication year - 2010
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2009.03664.x
Subject(s) - medicine , incidence (geometry) , prospective cohort study , deep vein , mechanical ventilation , thrombosis , venous thrombosis , complication , anesthesia , retrospective cohort study , surgery , physics , optics
Summary. Background : Deep vein thrombosis (DVT) is a major complication in intensive care units (ICU) but dedicated guidelines on its management are still lacking. Objectives and Methods : This study investigated the effect of a 1‐year educational program for the implementation of DVT prophylaxis on the incidence of inferior limb DVT in a mixed‐bed ICU that admits high‐risk surgical and trauma patients, investigated during a first retrospective phase [126 patients, SAPS II score 42 (28–54)] and a following prospective phase [264 patients, SAPS II score II 41 (27–55)]. The role of baseline and time‐dependent DVT risk factors in DVT occurrence was also investigated during the prospective phase. Results : The educational program on implementation of DVT prophylaxis was associated with a significant decrease in DVT incidence from 11.9% to 4.5% ( P < 0.01) and in the mean length of ICU stay ( P < 0.01). Combined with pharmacological prophylaxis, the use of elastic compressive stockings significantly also increased in the prospective phase ( P < 0.01). The duration of mechanical ventilation, vasopressor administration and neuromuscular block were significantly different between DVT‐positive and DVT‐negative patients ( P < 0.01). Multivariate analysis identified neuromuscular block as the strongest independent predictor for DVT incidence. Conclusion : One‐year ICU‐based educational programs on implementation of DVT prophylaxis were associated with a significant decrease in the incidence of DVT and also in the length of stay in ICU.