Venous thromboembolism after hospital discharge.
Several methods of prophylaxis have significantly reduced the risk of developing VTE during hospital admission. There is a current tendency toward a reduction in the hospital stay, which does not necessarily mean that patients are protected from experiencing thrombotic complications after leaving the hospital. A number of patients will develop DVT and PE after hospital discharge if prophylaxis is prematurely discontinued while they persist at risk. Further studies are necessary to establish whether extending prophylaxis beyond discharge will reduce the rate of late-onset thromboses and which are the best prophylactic alternatives for the different patient groups at risk. Meanwhile, it is our standard of practice to utilize a combination of GES and either low-dose heparin or warfarin, at least for 3 or 4 weeks after discharge in high-risk patients. In countries where low molecular weight heparins are available, these agents represent an attractive alternative to unfractionated heparin because of their better dosage schedule and safety profile.
Arcelus
J I
JI
Department of Surgery Glenbrook Hospital, Glenview, Illinois 60025.
Caprini
J A
JA
Traverso
C I
CI
D006801:Humans; D010351:Patient Discharge; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000517:prevention & control; D013923:Thromboembolism / Q000517:prevention & control*; D013924:Thrombophlebitis / Q000517:prevention & control; D013997:Time Factors