Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jun 25:18:e20180107.
doi: 10.1590/1677-5449.180107.

Role of ambulation to prevent venous thromboembolism in medical patients: where do we stand?

Maria Chiara Chindamo  1   2 , Marcos Arêas Marques  3   4
Affiliations
Review

Role of ambulation to prevent venous thromboembolism in medical patients: where do we stand?

Maria Chiara Chindamo et al. J Vasc Bras. .

Abstract
in English, Portuguese

Venous thromboembolism (VTE) encompasses the spectrum of manifestations of deep venous thrombosis and/or pulmonary embolism and is a common, serious, and preventable complication in hospitalized patients. Although immobility plays an important role in determining VTE risk in medical patients, no clear and uniform criteria exist to guide clinicians in assessing immobility. The variation in the descriptions that do exist makes it difficult to interpret and compare the results of randomized clinical trials with respect to the influence of different levels of immobility on the magnitude of VTE risk and the role that early ambulation as an isolated factor plays in prevention of such events. Understanding these limitations is a prerequisite for the proper use and interpretation of VTE risk assessment tools and for indicating the best strategy for preventing venous thrombosis in hospitalized medical patients. The objective of this study was to review the main evidence reported in the literature on the role of ambulation in prevention of VTE.

Resumo: O tromboembolismo venoso (TEV), que compreende o espectro de manifestações de trombose venosa profunda e/ou embolia pulmonar, é uma complicação comum, grave e evitável em pacientes hospitalizados. Embora a perda da mobilidade recente ou continuada represente um dos principais fatores de risco relacionados ao desenvolvimento de TEV, não existem critérios claros e uniformes para a definição do conceito de imobilidade. A diversidade dessas descrições dificulta a interpretação e a comparação dos resultados de estudos clínicos randomizados no que se refere à influência dos diferentes níveis de imobilidade na magnitude do risco de TEV e ao papel da deambulação precoce, de forma isolada, na prevenção de tais eventos. O entendimento dessas limitações é mandatório para a utilização e interpretação adequadas das ferramentas de avaliação de risco de TEV, e para a indicação da melhor estratégia de prevenção de trombose em pacientes clínicos hospitalizados. O objetivo deste estudo é revisar as principais evidências da literatura quanto ao papel da deambulação na prevenção do TEV.

Keywords: deep venous thrombosis; mobility limitation; patient safety; pulmonary embolism; thromboprophylaxis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

References

    1. Lindblad B, Sternby NH, Bergqvist D. Incidence of venous thromboembolism verified by necropsy over 30 years. BMJ. 1991;302(6778):709–711. doi: 10.1136/bmj.302.6778.709. - DOI - PMC - PubMed
    1. Alikhan R, Peters F, Wilmott R, Cohen AT. Fatal pulmonary embolism in hospitalized patients: a necropsy review. J Clin Pathol. 2004;57(12):1254–1257. doi: 10.1136/jcp.2003.013581. - DOI - PMC - PubMed
    1. Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2) Suppl 2:e195S–226S. doi: 10.1378/chest.11-2296. - DOI - PMC - PubMed
    1. Dobesh P. The importance of appropriate prophylaxis for the prevention of venous thromboembolism in at-risk medical patients. Int J Clin Pract. 2010;64(11):1554–1562. doi: 10.1111/j.1742-1241.2010.02447.x. - DOI - PubMed
    1. Weill-Engerer S, Meaume S, Lahlou A, et al. Risk factors for deep vein thrombosis in inpatients aged 65 and older: a case-control multicenter study. J Am Geriatr Soc. 2004;52(8):1299–1304. doi: 10.1111/j.1532-5415.2004.52359.x. - DOI - PubMed

LinkOut - more resources