1. Venous thromboembolism risk stratification and thromboprophylaxis with low molecular weight heparin in patients undergoing major ambulatory surgery: an observational prospective study.
- Author
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Lozano, F. S., Sanchez-Fernandez, J., Santos, J. A., Garcia-Alovio, J., Mateos, R., Gonzalez-Porras, J. R., and Alberca, I.
- Subjects
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THROMBOEMBOLISM risk factors , *VEIN diseases , *HEMORRHAGE risk factors , *AMBULATORY surgery , *ANALYSIS of variance , *CHI-squared test , *COMPUTER software , *ECHOCARDIOGRAPHY , *HEPARIN , *LONGITUDINAL method , *SCIENTIFIC observation , *HEALTH outcome assessment , *PREANESTHETIC medication , *RISK assessment , *THROMBOEMBOLISM , *VEINS , *DATA analysis , *TREATMENT effectiveness , *DISEASE risk factors ,THROMBOEMBOLISM prevention - Abstract
Aim: Although supposedly low, the risk of venous thromboembolism (VTE) after major ambulatory surgery (MAS) remains to be established. We have carried out a prospective validation of the risk stratification of VTE in MAS patients. Methods: 402 consecutive patients were stratified according to a Spanish consensus as: a) no risk of VTE (n=141), b) moderate risk (n=228), and c) high risk (n=33). The moderate and high risk groups received thromboprophylaxis with low molecular weight heparin. On post-operative day 10, a colour Echo-Doppler was obtained; on days 10 and 30 different parameters of efficacy and safety were measured. Results: 357 patients completed the study. No symptomatic events were observed; one case of asymptomatic deep vein thrombosis was observed. Overall, in 39 patients (three from the low risk group and 36 in the moderate and high risk groups; p<0.001) a decrease to 15 cm/s was observed in interior femoral blood flow. Haemorrhagic complications, all of them minor, in the surgical wound accounted for 2%. The study of thrombophilia revealed a high number of patients with hidden thrombophilia (28.1%). Conclusion: MAS patients are not free of VTE events and require risk stratification. Thromboprophylaxis with LMWH in moderate and high risk of VTE is safe and effective. [ABSTRACT FROM AUTHOR]
- Published
- 2010