| Thromboprophylaxis in surgical patients. | |
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MedLine Citation:
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PMID: 12691354 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Venous thromboembolism is the most common preventable cause of death in surgical patients. Thromboprophylaxis, using mechanical methods to promote venous outflow from the legs and antithrombotic drugs, provides the most effective means of reducing morbidity and mortality in these patients. Despite the evidence supporting thromboprophylaxis, it remains underused because surgeons perceive that the risk of venous thromboembolism is not high enough to justify the potential hemorrhagic complications of anticoagulant use. The risk of venous thromboembolism is determined by patient characteristics and by the type of surgery that is performed. In this paper we identify the risk factors for venous thromboembolism and provide a scheme for stratifying surgical patients according to their risk. We describe the mechanism of action of the various forms of thromboprophylaxis and outline the evidence supporting thromboprophylaxis in different surgical settings. Finally, we recommend optimal forms of thromboprophylaxis in patients who undergo various types of surgery. Intermittent pneumatic compression, with or without elastic stockings, can be used for thromboprophylaxis in patients who undergo neurosurgical procedures; for patients who undergo vascular or cardiovascular procedures, long-term acetylsalicylic acid should be used for thromboprophylaxis. Low-molecular-weight heparin (LMWH) or warfarin is the choice for patients with spinal cord operations and all patients with major trauma who do not have contraindications to anticoagulation should receive thromboprophylaxis with LMWH. |
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Authors:
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Martin O'Donnell; Jeffrey I Weitz |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Canadian journal of surgery. Journal canadien de chirurgie Volume: 46 ISSN: 0008-428X ISO Abbreviation: Can J Surg Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-14 Completed Date: 2003-04-25 Revised Date: 2011-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0372715 Medline TA: Can J Surg Country: Canada |
Other Details:
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Languages: eng Pagination: 129-35 Citation Subset: IM |
Affiliation:
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Henderson Research Centre, McMaster University, Hamilton, Ont. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anticoagulants
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therapeutic use Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee Bandages Heparin, Low-Molecular-Weight / therapeutic use Humans Risk Assessment Risk Factors Spinal Cord Injuries / surgery Surgical Procedures, Elective Surgical Procedures, Operative / adverse effects* Thromboembolism / etiology, prevention & control* Venous Thrombosis / etiology, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Heparin, Low-Molecular-Weight |
| Comments/Corrections | |
Comment In:
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Can J Surg. 2003 Apr;46(2):90-1
[PMID:
12691343
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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