Association Between Missed Doses of Chemoprophylaxis and VTE Incidence in a Statewide Colectomy Cohort.
Association Between Missed Doses of Chemoprophylaxis and VTE Incidence in a Statewide Colectomy Cohort.
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DOI：
10.1097/sla.0000000000004349
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发表时间：
2021-04-01
影响因子：
9
通讯作者：
Yang AD
中科院分区：
文献类型：
--
作者：
Khorfan R;Kreutzer L;Love R;Schlick CJR;Chia M;Bilimoria KY;Yang AD
化学预防降低了术后静脉血栓栓塞症(VTE)的发生率，VTE是可预防的住院患者死亡的主要原因。单一机构的研究表明，住院患者错过剂量的化学预防是常见的，并与发生VTE有关。1、2一项卫生系统范围的研究发现，在学术医院和社区医院，漏服剂量都很常见。3“无缺陷”VTE预防的概念已经出现，它包括最佳风险适当预防的处方和按处方给予的每一剂量。4伊利诺伊州外科质量改进协作体(ISQIC)是由56家学术和社区医院组成的协作体，致力于提高伊利诺伊州的外科护理质量。ISQIC实施了一种新的全面的住院患者VTE预防流程措施，以解决现有质量措施的缺陷，例如无法准确识别错过的化学预防剂量。4、5先前对ISQIC医院的一项分析发现，在18%的结肠切除术中，未能提供无缺陷的住院患者VTE化学预防，错过的剂量是主要原因。6.
Chemoprophylaxis reduces the incidence of postoperative venous thromboembolism (VTE), the leading cause of preventable inpatient death. Single-institution studies suggest that missed doses of inpatient chemoprophylaxis are common and associated with developing VTE. 1, 2 One health system-wide study found that missed doses were common at both academic and community hospitals. 3 The concept of “defect-free” VTE prophylaxis has emerged, which includes prescription of optimal risk-appropriate prophylaxis and administration of every dose as prescribed. 4The Illinois Surgical Quality Improvement Collaborative (ISQIC) is a collaborative of 56 academic and community hospitals dedicated to improving the quality of surgical care in Illinois. ISQIC implemented a novel comprehensive postoperative inpatient VTE prophylaxis process measure to address shortcomings of existing quality measures such as the inability to accurately identify missed chemoprophylaxis doses. 4, 5 A previous analysis of ISQIC hospitals identified failure to provide defect-free postoperative inpatient VTE chemoprophylaxis in 18% of colectomies, with missed doses being a major contributor. 6