Prophylaxis for Deep Venous Thrombosis and Troublesome Bleeding
Prophylaxis for Deep Venous Thrombosis and Troublesome Bleeding
Leonardi MJ, McGory ML, Ko CY
Arch Surg. 2006;141:790-799
How often does prophylaxis for deep venous thrombosis (DVT) lead to troublesome bleeding? To determine the risk, the authors performed a meta-analysis of 33 randomized trials (33,813 patients) covering the years 1965 to 2005. The pharmacologic agents used for DVT prevent were low-molecular-weight or low-dose unfractionated heparin. The most common complications were bruising at the injection site (6.9%) and wound hematoma (5.5%). More serious complications, such as gastrointestinal bleeding (0.4%) or retroperitoneal bleeding (0.4%), were rare. Of the entire group of patients, 0.7% or 237 patients were reoperated because of a bleeding problem.
Providing perioperative DVT prophylaxis is now a quality issue in the management of surgical patients. This article is reassuring because the results indicate that complications of DVT prophylaxis are uncommon, and serious complications are rare. The authors point out that specific concerns about using DVT prophylaxis exist in surgical patients and they provide a list of guidelines from the American Society of Regional Anesthesia.
Abstract
Leonardi MJ, McGory ML, Ko CY
Arch Surg. 2006;141:790-799
How often does prophylaxis for deep venous thrombosis (DVT) lead to troublesome bleeding? To determine the risk, the authors performed a meta-analysis of 33 randomized trials (33,813 patients) covering the years 1965 to 2005. The pharmacologic agents used for DVT prevent were low-molecular-weight or low-dose unfractionated heparin. The most common complications were bruising at the injection site (6.9%) and wound hematoma (5.5%). More serious complications, such as gastrointestinal bleeding (0.4%) or retroperitoneal bleeding (0.4%), were rare. Of the entire group of patients, 0.7% or 237 patients were reoperated because of a bleeding problem.
Providing perioperative DVT prophylaxis is now a quality issue in the management of surgical patients. This article is reassuring because the results indicate that complications of DVT prophylaxis are uncommon, and serious complications are rare. The authors point out that specific concerns about using DVT prophylaxis exist in surgical patients and they provide a list of guidelines from the American Society of Regional Anesthesia.
Abstract
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