Thromboprophylaxis in the surgical patient Tromboprofilaxis en el paciente quirúrgico

Abstract

Venous thromboembolic disease (VTD), manifested as deep venous thrombosis (DVT), pulmonary embolism or both, is a source of morbidity and mortality in patientes undergoing surgery. Pulmonary embolism is the most common cause of preventable death in patient hospitalized for surgical procedures. The risk of VTD is determined by combination of individual predisposing factors and the specific type of surgery. At moment, routine and systematic prophylaxis whit pharmacological and/or mechanical methods, is the best strategy to reduce TED after surgery, in patient at risk. Without prophylaxis, the incidence of DVT is about 14% in gynaecological surgery, 22% in neurosurgery, 26% in abdominal surgery and 45-60% in orthopaedic surgery. In patients with malignancy these rates are markedly higher. However, although we have this knowledge and the availability of effective prophylactic methods and consensus guidelines, VTD is still a major problem in surgery. This article reviews the current evidenc