Prescription of Pharmacologic Venous Thromboembolism Prophylaxis Upon Hospital Discharge After Surgery for Lower Limb Fracture—A 3-Center Study in the North-West of England

Abstract

Purpose
The risk of venous thromboembolism (VTE) after surgery for lower limb trauma may be reduced with pharmacologic prophylaxis upon hospital admission and hospital discharge. To determine the rate and duration of prescription of VTE pharmacologic prophylaxis upon hospital discharge in patients who have surgery for a lower limb fracture.

Methods
Retrospective analysis of patients who had surgery for a lower limb fracture at 3 National Health Trust hospitals in the North-West of England.

Findings
Data from 127 patients were collected. All patients were prescribed pharmacologic VTE prophylaxis upon hospital admission, and 125 (98%) upon discharge, with 91.3% of patients discharged with low-molecular weight heparin. There was substantial variation in the duration of pharmacologic VTE prescription upon hospital discharge, with a median duration of 42 days (interquartile range, 28–42 days; range, 1–84 days). In our cohort, 7 (5.5%) of patients were prescribed VTE prophylaxis for less than 14 days, and 30(23.6%) prescribed for less than 35 days.

Implications
This study reported that pharmacologic prophylaxis for VTE was prescribed for almost all patients upon hospital discharge. However, there was substantial variation in the duration of the prescribed prophylaxis upon hospital discharge, with almost a quarter of patients prescribed less than 35 days. National level prescription guidance for VTE prophylaxis upon hospital discharge may improve consistency within and between centers.