Evidence summary on perioperative non-pharmacological prophylaxis of venous thromboembolism in patients with pancreatic cancer

胰腺癌患者围手术期非药物预防静脉血栓栓塞的证据总结

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Abstract

OBJECTIVE: To summarize the best evidence related to perioperative non-pharmacologic prophylaxis of venous thromboembolism in patients with pancreatic cancer, and improve the quality of clinical practice. METHODS: According to the "6S" evidence pyramid model, we searched guideline networks, professional society websites, and comprehensive databases for clinical decisions, clinical guidelines, expert consensus, evidence summaries, and systematic reviews related to perioperative non-pharmacological prophylaxis of venous thromboembolism in patients with pancreatic cancer. The literature quality assessment followed appropriate tools. If there were any conflicts about the conclusions drawn from different sources of evidence, this study followed the principle of high-quality evidence and the latest published authoritative literature priority. The "JBI Evidence Pre-grading and Evidence Recommendation Level System 2014" was adopted for the evidence lacking a grading system. RESULTS: Nineteen studies were included, including 7 guidelines, 5 expert consensus, 2 clinical decisions, 3 evidence summaries, and 2 systematic reviews. Twenty-three pieces of best evidence were summarized in five aspects: risk assessment, mechanical prophylactic devices, initiation and duration of non-pharmacological prevention, implementation strategies, and health education. CONCLUSIONS: The 23 pieces of evidence in five aspects we summarized provide scientific references for clinical caregivers to develop perioperative venous thromboembolism prophylaxis for pancreatic cancer patients. In addition, in order for evidence to be effectively used to improve the quality of clinical practice, clinical caregivers should consider patient preferences and explore barriers to the evidence translation and application. SYSTEMATIC REVIEW REGISTRATION: This study has been registered on the Fudan University Centre for Evidence-based Nursing (Registation No. ES20233506).

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