Duration of deep vein thrombosis prophylaxis in the surgical patient and its relation to quality issues.
BACKGROUND
Venous thromboembolism (VTE) is a major cause of mortality and morbidity in patients after major surgery. The US Acting Surgeon General issued a "call to action" to reduce the number of VTE cases nationwide.


METHODS
PubMed literature searches were performed to identify original studies.


CONCLUSIONS
Noncompliance with VTE guidelines is common in clinical practice. Thromboprophylaxis is frequently stopped on discharge, not meeting recommendations for standard-duration prophylaxis (7-10 days) because of shorter hospital stays or for extended-duration prophylaxis (10-35 days). Appropriate pharmacologic prophylaxis options for orthopedic surgery patients include the low-molecular-weight heparins (LMWHs), fondaparinux, or warfarin (10-35 days). For patients undergoing abdominal surgery for cancer, the LMWHs are recommended beyond hospitalization (up to 28 days). Performance measures should help establish VTE-prevention policies that close the gap between guideline recommendations and clinical practice in a greater number of hospitals.
Muntz
James
J
University of Texas Health Center, Houston, 77030, USA. jmuntz@tmhs.org
D000925:Anticoagulants / Q000008:administration & dosage*; D019983:Guideline Adherence; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D011787:Quality of Health Care; D012307:Risk Factors; D013997:Time Factors; D020246:Venous Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants