Thromboprophylaxis in hospitalized trauma patients: a systematic review and meta-analysis of implementation strategies

IntroductionVenous thromboembolism (VTE) prophylaxis implementation strategies are well-studied in some hospitalized medical and surgical patients. Although VTE is associated with substantial mortality and morbidity in trauma patients, implementation strategies for the prevention of VTE in trauma ap...

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Bibliographic Details
Published in:Trauma surgery & acute care open 2024-04, Vol.9 (1), p.e001420-e001420
Main Authors: Ratnasekera, Asanthi, Seng, Sirivan S, Ciarmella, Marina, Gallagher, Alexandria, Poirier, Kelly, Harding, Eric Shea, Haut, Elliott R, Geerts, William, Murphy, Patrick
Format: Article
Language:English
Subjects:
Audits
Compliance
Costs
Disease prevention
Education
Feedback
guideline
Hospitalization
Intervention
Meta-analysis
Mortality
Order entry
quality improvement
Systematic Review
Thrombocytopenia
Thromboembolism
Thrombosis
Venous thromboembolism
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Summary:IntroductionVenous thromboembolism (VTE) prophylaxis implementation strategies are well-studied in some hospitalized medical and surgical patients. Although VTE is associated with substantial mortality and morbidity in trauma patients, implementation strategies for the prevention of VTE in trauma appear to be based on limited evidence. Therefore, we conducted a systematic review and meta-analysis of published literature on active implementation strategies for VTE prophylaxis administration in hospitalized trauma patients and the impact on VTE events.MethodsA systematic review and meta-analysis was performed in adult hospitalized trauma patients to assess if active VTE prevention implementation strategies change the proportion of patients who received VTE prophylaxis, VTE events, and adverse effects such as bleeding or heparin-induced thrombocytopenia as well as hospital length of stay and the cost of care. An academic medical librarian searched Medline, Scopus, and Web of Science until December 2022.ResultsFour studies with a total of 1723 patients in the active implementation strategy group (strategies included education, reminders, human and computer alerts, audit and feedback, preprinted orders, and/or root cause analysis) and 1324 in the no active implementation strategy group (guideline creation and dissemination) were included in the analysis. A higher proportion of patients received VTE prophylaxis with an active implementation strategy (OR=2.94, 95% CI (1.68 to 5.15), p
ISSN:2397-5776
2397-5776
DOI:10.1136/tsaco-2024-001420