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Dig Dis Sci. 2013 Jan;58(1):46-52. doi: 10.1007/s10620-012-2435-6. Epub 2012 Oct 7.

Physicians' perceptions of risks and practices in venous thromboembolism prophylaxis in inflammatory bowel disease.

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1
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, 600 University Ave, Suite 437, Toronto, ON, M5G 1X5, Canada.

Abstract

BACKGROUND:

Hospitalized inflammatory bowel disease (IBD) patients are at a higher risk of venous thromboembolism (VTE).

AIMS:

We aimed to determine perceptions of VTE risks and self-reported practices regarding VTE prophylaxis in hospitalized IBD patients among American gastroenterologists.

METHODS:

Gastroenterologists who were members of the American Gastroenterological Association (AGA) and cared for IBD patients in the preceding 12 months were included. A survey assessed physicians' perceptions of VTE risks and their practices regarding VTE prophylaxis among IBD inpatients and other factors that may influence the decision to provide prophylaxis.

RESULTS:

A total of 135 eligible gastroenterologists responded to the survey, 77 % of whom practiced in academic settings. Most physicians (84%) reported having had IBD patients develop VTE. Only 67% cared for IBD patients in hospitals that had protocols for VTE prophylaxis, and 45% were aware of any published guidelines for VTE prophylaxis in hospitalized IBD patients. While only 7% believed that any rectal bleeding was a contraindication to VTE chemoprophylaxis in hospitalized IBD patients with flares, 14% never administered prophylaxis to IBD inpatients. A significant number of respondents felt that hospitalized IBD patients who were ambulatory (24%) or in remission (28%) did not require VTE prophylaxis. There was wide variation on recommendations for duration of anticoagulation for a first unprovoked VTE in an IBD patient.

CONCLUSIONS:

There is significant variation in reported practices for VTE prophylaxis in IBD patients among gastroenterologists. A more standardized approach to VTE prophylaxis should be implemented to improve health outcomes for IBD inpatients.

PMID:
23053902
DOI:
10.1007/s10620-012-2435-6
[Indexed for MEDLINE]
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