Thromboprophylaxis for Prevention of Venous Thromboembolism: Practice Patterns Among American Head and Neck Society Members

Abstract

Objectives:

VTE is associated with significant morbidity and is the most common cause of preventable death in hospitalized patients. Although there are no society-specific guidelines for VTE prevention in otolaryngology, there is evidence to support routine use of chemoprophylaxis in high-risk patients. The objective of this study is to evaluate current methods of perioperative thromboprophylaxis.

Study Design:

Cross-sectional study.

Methods:

An online survey addressing practices related to VTE prevention was distributed to AHNS members via Survey Monkey between July 9, 2024 and August 1, 2024. Physician and practice demographics, training, and patterns of thromboprophylaxis were characterized and evaluated.

Results:

Complete survey responses were obtained from 56 AHNS members. Among these, 64% (n = 36) completed an AHNS-accredited fellowship and 57% (n = 32) practiced in an academic setting. Two-thirds of respondents (n = 38; 68%) routinely prescribe some form of chemoprophylaxis, the most common being low molecular weight heparin (n = 37; 66%), followed by unfractionated heparin (n = 9; 16%). Of the respondents who did not routinely prescribe chemical prophylaxis, common reasons included a perceived low rate of VTE (n = 5; 9%) and lack of clear recommendations for VTE prevention (n = 7; 13%). Despite this, 39% (n = 22) reported having at least 1 patient who experienced perioperative VTE in the past 12-months.

Conclusions:

Although the majority of AHNS respondents support routine perioperative chemoprophylaxis, there is a wide variety of practice patterns. Future prospective studies and development of otolaryngology—specific guidelines would serve to unify practice patterns and improve patient outcomes.