Thromboprophylaxis for ambulatory surgery: Results from a prospective national cohort - 31/07/18
, Dan Benhamou b, Frédéric Aubrun c, Jean-Luc Bosson d, Pierre Albaladejo d, eBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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Highlights |
• | Few guidelines on venous thromboembolism prophylaxis are available for ambulatory surgery. |
• | The OPERA study shows heterogeneity in the care of these patients. |
• | Only 40% of centres had a written procedure. |
• | Low molecular weight heparins are favoured. |
Abstract |
Background |
Venous thromboembolism (VTE) prophylaxis is not always part of the usual care of ambulatory surgery patients, and few guidelines are available.
Objectives |
To collect data on the application of VTE prophylaxis in ambulatory patients.
Design |
The OPERA study is a large national survey performed in 221 healthcare facilities.
Patients |
Among patients, 2174 who underwent one of ten selected procedures over two pre-defined days of investigation.
Main outcome measures |
Assessment and management of the postoperative VTE risk.
Results |
The postoperative VTE risk was assessed as nil (4.1% of the physicians), low (74%) or moderate (20%). This risk was assessed as lower (71%) in ambulatory surgery as compared to conventional surgery. In most centres (94%), a personal patient history of VTE was recorded preoperatively, and in 72% a prophylaxis protocol was systematically applied but only 40% of the responding centres had a written protocol for VTE prophylaxis. The postoperative period (discharge at home) was covered by a VTE protocol for 75% of the centres, with VTE prophylaxis starting postoperatively in 21% of the patients. In these patients, different treatments were applied: below-knee compression stockings (25%); thigh-length compression stockings (21%); intermittent pneumatic compression in the recovery room (1.2%); unfractionated heparin (2.0%); low molecular weight heparins (65%); vitamin K antagonists (0.5%); other treatments, including direct oral anticoagulants (0.5%).
Conclusion |
These data underline the need for a better assessment of the VTE risk in ambulatory patients and new studies either with conventional or new agents to be able to build guidelines in this new setting.
El texto completo de este artículo está disponible en PDF.Keywords : Venous thromboembolism prophylaxis, Low molecular weight heparin, Ambulatory surgery, Graduated compression stockings
Esquema
Vol 37 - N° 4
P. 343-347 - août 2018 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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