title: Sequential compression devices as prophylaxis for venous thromboembolism in high-risk colorectal surgery patients: reconsidering American Society of Colorectal Surgeons parameters.
abstract: The American Society of Colorectal Surgeons (ASCRS) recently endorsed low-molecular-weight heparin and low-dose heparin as primary prophylaxis for venous thromboembolism (VTE) in highest-risk patients. Our study evaluates the feasibility of sequential compression device (SCD) use for VTE prophylaxis in these patients. Computerized databases of discharge diagnoses from three hospitals were reviewed. All patients with colorectal cancer or inflammatory bowel disease during a 7-year period were identified. Those who underwent major abdominal surgery and received VTE prophylaxis exclusively with SCDs were selected for the study. Patients diagnosed with postoperative VTE were identified through review of the three databases and of patient records for 90 days after surgery. One thousand two hundred eighty-one patients classified as highest-risk under the published ASCRS parameters underwent major abdominal surgery and received SCDs perioperatively. The incidence of clinically detectable postoperative VTE was 0.78 per cent. There were trends toward lower incidence among patients with malignancy (0.53%) compared with inflammatory bowel disease (1.48%, P = 0.09), and those with abdominal compared to pelvic procedures (0.62% vs. 1.04%, P = 0.41). Prophylaxis for perioperative VTE solely with SCD is a viable option for patients classified as highest-risk under ASCRS parameters.
authors: Department of Colon and Rectal Surgery of the Keck School of Medicine at the University of Southern California, Los Angeles, California 90033, USA.
authors: Jesus I
authors: JI
authors: Ramirez
authors: Pantelis
authors: P
authors: Vassiliu
authors: Claudia
authors: C
authors: Gonzalez-Ruiz
authors: Petar
authors: P
authors: Vukasin
authors: Adrian
authors: A
authors: Ortega
authors: Andreas M
authors: AM
authors: Kaiser
authors: Robert W
authors: RW
authors: Beart
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001458:Bandages; D003106:Colon / Q000601:surgery*; D005240:Feasibility Studies; D006493:Heparin / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000517:prevention & control*; D012007:Rectum / Q000601:surgery; D020246:Venous Thrombosis / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin