Mechanical prophylaxis to prevent venous thromboembolism in surgical patients: A prospective trial evaluating compliance

Purpose: Sequential compression devices (SCDs) and venous foot pumps (VFPs) are used to prevent venous thromboembolism in surgical patients, but compliance is presumed to be poor. We evaluated compliance with these devices, compared compliance between intensive care unit (ICU) and non-ICU patients, and identified factors associated with better compliance. Materials and Methods: Compliance was prospectively evaluated twice daily from admission until discharge, ambulation, or device discontinuation. A compliance score was determined by dividing the number of compliant evaluations by the total number of assessments. Compliance was compared between ICU and non-ICU patients, and predictors for compliance were identified. Results: There were 150 patients evaluated. Overall compliance was 73 +/- 29. Compliance was higher in ICU patients compared to non-ICU patients (82 +/- 22 vs 62 +/- 32; P < .001). Admission to the ICU (odds ratio [OR], 2.21 [1.04-4.65]; P = .038) and SCD use (as opposed to VFP) (OR, 2.94 [1.36-6.37]; P = .006) were independent predictors for better compliance. Conclusions: Compliance with mechanical prophylaxis is suboptimal particularly in non-ICU patients. Strategies to improve compliance or alternative prophylaxis should be considered in those patients. (C) 2009 Elsevier Inc. All rights reserved.