Türk kalp damar cerrahları arasında uluslararası normalleştirilmiş oran uygulamalarındaki farklılıklar: Günlük uygulamaya kıyasla kılavuzlar

Amaç: Bu çalışmada, Türk kalp damar cerrahlarının günlük uygulamada kılavuzlara uyumluluk derecesi araştırıldı. Çalışma planı: Bu çalışmaya Mayıs 2016 - Haziran 2016 tarihleri arasında toplam 314 kalp damar cerrahı dahil edildi. Katılımcılara Türk Kalp Damar Cerrahisi Derneği Yönetim Kurulu tarafından onaylanmış varfarin kullanımına ilişkin 18 maddelik bir anket uygulandı. Anket, dernek üyelerine elektronik posta yoluyla iki kere gönderildi ve veriler toplandı. Bulgular: Toplanan verilere göre, Türk Kalp Damar Cerrahisi Derneği Kalp Damar Cerrahisi Temel Bilimler Çalışma Grubu tarafından bir rapor hazırlandı. Türk kalp damar cerrahlarının mitral kapak tamiri ve biyoprotez kapak replasmanında daha düşük uluslararası normalleştirilmiş oran hedeflerini takip ettiği tespit edildi. Mekanik kapak protezlerinde ve atriyal fibrilasyonda, çoğunlukla kılavuzda tanımlanmış hedefleri uyguluyorlardı. Sonuç: Önemli kılavuz bilgilerini yaygınlaştırmak için derneğimiz tarafından kısa kurslar veya bilgilendirmeler planlanmalıdır. Bu, duyarlılığı ve kanıta dayalı ve evrensel olarak kabul edilen kılavuza dayalı uygulamayı da artıracaktır. Telif hakkı sorunlarının çözüme kavuşturulması durumunda, derneğin web sitesinde kılavuzların çevirileri yayımlanabilir. Uluslararası normalleştirilmiş oranların takibi için, basit ve hızlı bir test olan hasta başı test kullanımı özendirilmelidir.

Variations in international normalized ratio applications among Turkish cardiovascular surgeons: Daily practice versus Guidelines

Background: In this study, we aimed to investigate the degree of guideline compliance for warfarin use among the Turkish cardiovascular surgeons in daily practice.Methods: Between May 2016 and June 2016, a total of 314 cardiovascular surgeons were included in this study. The participants were administered an 18 item-questionnaire for warfarin use, which was approved by the Executive Board of the Turkish Society of Cardiovascular Surgery for the issues related with warfarin use. The questionnaire was sent via electronic mail to the members of the society twice and data were collected.Results: Based on the collected data, a report was prepared by the Working Group for Cardiovascular Basic Sciences of the Turkish Society of Cardiovascular Surgery. It was found that the Turkish cardiovascular surgeons followed lower international normalized ratio targets for mitral valve repair and bioprosthetic valves at any position. For mechanical valve prostheses and atrial fibrillation, they mostly applied targets defined in the guidelines.Conclusion: Brief courses or acknowledgements should be planned by our society to disseminate this critical guideline information. This would increase awareness and increase guideline-based practice which is evidence-based and universally accepted. Translations of guidelines may be also shared on the website of the society, if copyright issues are settled. For the international normalized ratio monitorization, the use of point-of-care testing, a simple and quick test, should be encouraged.

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