Clinical research
A survey to establish current methods of venous thromboembolism prophylaxis in stroke patients practiced by Polish neurologists
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Submission date: 2012-12-04
Final revision date: 2013-03-27
Acceptance date: 2013-03-27
Online publication date: 2014-06-27
Publication date: 2014-06-30
Arch Med Sci 2014;10(3):470–476
Introduction: Venous thromboembolism (VTE) is associated with considerable morbidity and mortality in stroke patients. The purpose of our survey was to establish the current methods of VTE prophylaxis practiced by Polish neurologists. We also aimed to determine whether there is enough variation in practice to justify the development of an evidence-based guideline for VTE prevention.
Material and methods: Postal self-administered questionnaires about VTE prophylactic methods practiced by Polish neurologists were sent to 218 neurological wards where stroke is treated. If no response was received, the questionnaire was faxed and finally we attempted to obtain information by telephone.
Results: One hundred and seventy-six (80.7%) stroke centers of 218 responded. The majority (137/176; 77.8%) of centers had a stroke unit. The median admission rate of surveyed wards was estimated to be 320 patients/year (range from 20 to 1000 patients/year). The most common method of VTE prophylaxis reported was low molecular weight heparin (LMWH) (98.9%), and the least common was intermittent pneumatic compression (IPC) (6.8%). Centers admitting ≥ 200 patients/year (70.7% vs. 45%; p = 0.039), and those with stroke units (95 vs. 20; p = 0.031) were more willing to join a randomized trial evaluating any of the methods. All the centers participating in the survey reported a need for a detailed VTE prophylaxis guidelines.
Conclusions: The LMWH is the predominant VTE prophylaxis strategy for stroke patients practiced by Polish neurologists. Due to the variation of methods used in VTE prophylaxis it might be reasonable to further specify this section of stroke treatment guidelines.