PURPOSE: The aim of this study is to determine the perception of physicians toward DVT prophylaxis in a tertiary care center in Lebanon.
METHODS: A prospective study carried out at Makassed Hospital in Lebanon. The study tool included questions on the perception about the importance of DVT prophylaxis in different services and obstacles behind not giving it. The second part listed 10 medical and surgical clinical vignettes. The physicians were asked to specify the risk level for each case and identify the best type of DVT prophylaxis for that case. The physicians surveyed included attending and resident staff. All statistical analysis were made using SPSS program.
RESULTS: 68 physicians were surveyed, 38 (56%) were attending staff while 30 (44%) were residents. When asked whether DVT prophylaxis is important those who either agreed or strongly agreed were 19% and 79% for surgical patients and 41% and 59% in medical patients respectively. The percentage of agreement with the following risk factors for DVT among physicians were: age (91%), prior history of DVT (100%), obesity (97%), malignancy (94%), sepsis (87%), central venous catheters (66%), pregnancy/post partum (90%), and pneumonia (53%). The conditions physicians thought are contraindication for DVT prophylaxis were: active bleeding (97%), uncontrolled hypertension (59%), mild renal insufficiency (22%), coagulopathy (68%), spinal tap within 24 hours (50%), and recent intraocular surgery (78%). The degree of accuracy in allocating the correct DVT risk (high, moderate or low) for the clinical vignettes was only 58%. The choice of the correct prophylaxis strategy was correct in 72% of the cases. The lowest rate of correct answers was in the moderate risk vignette. The majority of physicians preferred LMWH for DVT prophylaxis. There were no significant statistical differences between attendings and residents or between different medical departments.
CONCLUSION: While awareness rate about importance of DVT prophylaxis exist the risk allocation and prophylaxis strategies were suboptimal among physicians surveyed.
CLINICAL IMPLICATIONS: Better education for physicians is needed mainly about risk assessment for DVT prophylaxis.
DISCLOSURE: Hani Lababidi, No Financial Disclosure Information; No Product/Research Disclosure Information