European guidelines on perioperative venous thromboembolism prophylaxis
- 1 February 2018
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in European Journal of Anaesthesiology
- Vol. 35 (2), 134-138
- https://doi.org/10.1097/eja.0000000000000706
Abstract
In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient management. For patients undergoing a low-risk procedure without additional risk factors, we recommend only general measures of thromboprophylaxis (early ambulation, optimal hydration) (Grade 1B). For patients undergoing a low-risk procedure with additional risk factors, or a high-risk procedure without additional risk factors, we recommend general measures of thromboprophylaxis (Grade 1B) and we suggest the administration of pharmacological prophylaxis with low molecular weight heparins (Grade 2B). For patients undergoing a high-risk procedure with additional risk factors we recommend general measures of thromboprophylaxis (Grade 1B) and pharmacological prophylaxis with low molecular weight heparins over other drugs (Grade 1B), or suggest specific mechanical measures in case of increased bleeding risk (Grade 2C). Pharmacological prophylaxis should last a minimum of 7 days (Grade 1B), although in selected cases of fast-track surgery, thromboprophylaxis could be limited to hospitalisation only (Grade 2C) and in specific cases of high-risk procedures, thromboprophylaxis could be extended for up to 4 weeks (Grade 2B).Keywords
This publication has 10 references indexed in Scilit:
- Effectiveness and safety of different duration of thromboprophylaxis in 16,865 hip replacement patients - A real-word, prospective observational studyThrombosis Research, 2014
- Is venous thromboprophylaxis necessary in patients undergoing minimally invasive surgery for a gynecologic malignancy?Gynecologic Oncology, 2014
- Thromboprophylaxis only during hospitalisation in fast-track hip and knee arthroplasty, a prospective cohort studyBMJ Open, 2013
- Identifying Patients at High Risk for Venous Thromboembolism Requiring Treatment After Outpatient SurgeryAnnals of Surgery, 2012
- Prevention of VTE in Orthopedic Surgery Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice GuidelinesChest, 2012
- Prevention of VTE in Nonorthopedic Surgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice GuidelinesChest, 2012
- Prevention of Venous Thromboembolism Using Enoxaparin in Day SurgeryClinical and Applied Thrombosis/hemostasis, 2011
- Multivariable Predictors of Postoperative Venous Thromboembolic Events after General and Vascular Surgery: Results from the Patient Safety in Surgery StudyJournal of the American College of Surgeons, 2007
- Return hospital visits and morbidity within 60 days after day surgery: a retrospective study of 18,736 day surgical proceduresActa Anaesthesiologica Scandinavica, 2006
- Thrombosis Risk Assessment as a Guide to Quality Patient CareDisease-a-Month, 2005