Preventing venous thromboembolism in surgical patients.
Hospital strategies to prevent VTE are important to reduce acute morbidity and mortality as well as the long-term consequences caused by venous stasis syndrome. Patients at low risk (eg, those who are ambulatory or undergoing a same-day procedure) or who are at high risk for bleeding (including those with severe renal impairment) are candidates for nonpharmacologic strategies for thromboembolic prophylaxis. Mechanical devices are effective if used appropriately, but compliance is a challenge. Patients who require a hospital stay of more than a day or two should receive a medication-based strategy, preferably using LMWH or fondaparinux. Patients undergoing hip replacement should receive extended prophylaxis with LMWH.
Section of Hospital Medicine, Department of General Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. michotf@ccf.org
Franklin A
FA
Michota
D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*