VTE prophylaxis probably does not work in non-orthopaedic surgical patients



Keywords: VTE, venous thrombembolism, PE, pulmonary embolism, Clexane, LMWH

DOI: (https://doi.org/10.1097/SLA.0000000000004646)

In a retrospective cohort study, Michigan investigators used a statewide collaborative of 63 hospitals to identify symptomatic postoperative VTEs among nonorthopedic surgical patients who received (≈22,000 patients) or did not receive (≈11,000 patients) postop pharmacologic VTE prophylaxis during hospitalizations between 2013 and 2017. Low-molecular-weight heparin or thrice-daily unfractionated heparin was considered to be appropriate pharmacologic prophylaxis.

In propensity-matched analysis, 30-day VTE rates were low (≈1.2%) and similar in postop patients who received or who didn't receive pharmacologic prophylaxis. Results were unchanged for low-, moderate-, and high-risk patients analyzed separately, and even very high–risk postop patients (i.e., Caprini score, >8) had no statistical difference in VTE rate (3.7% and 4.2%; P=0.09). Thirty-day mortality among all patients was similarly low and not different between groups (1.6% and 2.0%; P=0.06).


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