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Stricter DVT prophylaxis guidelines needed for cardiac and vascular surgery

Key clinical point: Intraoperative anticoagulation alone does not prevent DVT in patients undergoing vascular and cardiac surgery.

Major finding: The incidence of DVT according to the type of surgery was 2% for cardiac surgery, 0.99% for vascular surgery and 0.66% for general surgery.

Data source: Retrospective study of 2,669,772 surgery patients from the American College of Surgeons National Surgical Quality Improvement Program database.

Disclosures: The authors did not report any financial disclosures.


 

FROM ANNALS OF VASCULAR SURGERY

References

Cardiac and vascular surgery patients should receive deep vein thrombosis (DVT) prophylaxis before and after surgery, say researchers who found a high incidence of postoperative DVT in these patients compared to general surgery patients.

The retrospective study of 2,669,772 surgery patients from the American College of Surgeons National Surgical Quality Improvement Program database found that 18,670 patients developed a DVT within 30 days of the operation.

The incidence of DVT according to the type of surgery was 2% for cardiac surgery, 0.99% for vascular surgery and 0.66% for general surgery, reported Dr. Faisal Aziz and his colleagues at Pennsylvania State University (Ann. Vasc. Surg. 2015; 29: 661-9).

Vascular surgery patients were at 1.5 times the risk of a postop DVT and cardiac surgery patients were at 3 times the risk compared with general surgery patients, a significant difference.

Preoperative factors associated with increased risk of developing DVT in the postoperative period included inpatient admission status (OR 7.8), general anesthesia (OR 2), and dyspnea at rest (OR 5).

“Despite the fact that most arterial surgery operations involve administration of therapeutic doses of anticoagulation therapy during the operations, incidence of postoperative DVT is high in these patients,” the study authors wrote.

“Intraoperative anticoagulation is not protective against development of DVT in the postoperative period” they said.

“Physicians should ensure adequate DVT prophylaxis in postoperative vascular surgery and cardiac surgery patients, according to established evidence based guidelines,” they concluded.

The authors did not report any financial disclosures.

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