Duration of deep vein thrombosis prophylaxis in the surgical patient and its relation to quality issues

作者：Muntz James^*

来源：American Journal of Surgery, 2010, 200(3): 413-421.

DOI：10.1016/j.amjsurg.2009.05.045

• Extended-duration prophylaxis
• Quality improvement
• Surgery
• Venous thromboembolism
• Anticoagulation

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.
DATA SOURCES: PubMed literature searches were performed to identify original studies.
RESULTS AND 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.

• 出版日期2010-9