Venous Thromboembolism Risk Assessment and Thromboprophylaxis Practice in Nonorthopedic Hospitalized Surgical Patients: A Singapore's Perspective, Part 3: Is the Rate of Asian VTE as Low as Perceived?

Abstract Venous thromboembolism (VTE) remains a leading cause of preventable hospital mortality. Despite clear guidelines on risk assessment and prophylaxis, adherence varies worldwide. This study evaluated the perceptions and practices of VTE risk assessment and thromboprophylaxis among surgeons managing nonorthopedic hospitalized surgical patients in Singapore. A cross-sectional, anonymous online survey was conducted among consultant-grade surgeons across three public hospitals. The survey assessed perceptions of VTE incidence, use of risk assessment tools, and prophylaxis practices. Responses were analyzed by seniority, subspecialty, and training background. Forty-five surgeons responded: 35.5% were senior consultants, 48.9% consultants, and 15.5% associate consultants. 51.1% of the respondents routinely performed VTE risk assessments, while 68.9% routinely prescribed thromboprophylaxis. Senior consultants were less likely to perform formal risk assessments (31.3%) compared with associate consultants (71.4%) but more likely to prescribe prophylaxis. A perceived low incidence of VTE in Singapore (59.0%) was a key reason for omitting assessment. Prophylaxis was driven by perceived high patient risk (29.0%) and guideline adherence (38.7%). Most respondents (84.4%) supported routine assessment and prophylaxis. Suggested interventions included national guidelines, EMR-based tools, and continuing medical education. Uptake of VTE risk assessment and prophylaxis is moderate, with variability linked to seniority and training. The belief that VTE risk is low in Asian populations remains a barrier, despite rising incidence. National guidelines, EMR integration, and education may improve adherence and reduce preventable VTE events.