INTRODUCTION: @entity1211 remains a prominent cause of morbidity and mortality following @entity5 surgery. Although evidence-based guidelines recommend major @entity5 starts before incision and continues at least 7-10 days postoperatively, the extent to which the guidelines are followed is unknown. We assessed variation in thromboprophylaxis practices for @entity5 surgery in a regional surgical collaborative. METHODS: We studied abdominal resections for primary @entity344 in the Michigan Surgical Quality Collaborative from July 2012 to September 2013 (N  =  2967 @entity1 in 52 hospitals). We obtained detailed perioperative and postoperative pharmacologic and mechanical thromboprophylaxis information for @entity1 without documented exemptions (e.g., active bleeding, @entity566 ), and compared differences in procedure mix and operative complexity across hospitals based on their perioperative thromboprophylaxis rates. Additionally, we surveyed hospitals to identify variations in perioperative practice and barriers to prophylaxis administration. RESULTS: Overall, 40.4  % of eligible @entity1 had perioperative pharmacologic thromboprophylaxis for @entity5 surgery, and 25.3  % of the highest-risk @entity1 had evidence of inadequate postoperative prophylaxis (under-prophylaxis, either by dose or duration). Hospital perioperative thromboprophylaxis rates ranged from 0 to 96.1  %, and postoperative thromboprophylaxis rates ranged from 73.9 to 100  %. Epidural use was not independently associated with hospital pharmacologic thromboprophylaxis rates. CONCLUSIONS: Fewer than half of @entity1 undergoing @entity5 surgery receive perioperative thromboprophylaxis, and there is wide variation in @entity580 utilization despite strong evidence-based guidelines supporting its use.

Variation in Hospital Thromboprophylaxis Practices for XXXX Surgery.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['abdominal cancer', 'cancer surgery thromboprophylaxis', 'cancer'] @entity566 :: ('MESH:D006967', 'Disease') :: ['allergy'] @entity344 :: ('MESH:D005767', 'Disease') :: ['gastrointestinal, hepatopancreatobiliary (HPB), and neuroendocrine malignancies'] @entity580 :: ('MESH:D003428', 'Disease') :: ['hospital thromboprophylaxis'] @entity1211 :: ('MESH:D054556', 'Disease') :: ['Venous thromboembolism']
@entity5 :: (MESH:D009369,Disease) :: ['Abdominal Cancer']
