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- Title
Venous thromboembolism risk stratification and thromboprophylaxis with low molecular weight heparin in patients undergoing major ambulatory surgery: an observational prospective study.
- Authors
Lozano, F. S.; Sanchez-Fernandez, J.; Santos, J. A.; Garcia-Alovio, J.; Mateos, R.; Gonzalez-Porras, J. R.; Alberca, I.
- 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.
- Subjects
THROMBOEMBOLISM prevention; 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
- Publication
Ambulatory Surgery, 2010, Vol 16, Issue 1, p5
- ISSN
0966-6532
- Publication type
Article