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Review
. 2022 Jun 27:21:e20210195.
doi: 10.1590/1677-5449.202101951. eCollection 2022.

Challenges of extended venous thromboembolism prophylaxis in medical and surgical patients

Maria Chiara Chindamo  1   2 , Edison Ferreira Paiva  3 , Plinio Resende do Carmo Jr  1   2 , Ana Thereza Cavalcanti Rocha  4 , Marcos Arêas Marques  5   6
Affiliations
Review

Challenges of extended venous thromboembolism prophylaxis in medical and surgical patients

Maria Chiara Chindamo et al. J Vasc Bras. .

Abstract
in English, Portuguese

Patients hospitalized for acute medical and surgical illnesses are at risk of developing venous thromboembolism (VTE) during hospitalization and after discharge. Extended pharmacological prophylaxis beyond the hospital stay is recommended for patients undergoing surgeries at high risk for VTE and for selected groups of hospitalized medical patients. This practice involves several challenges, from identification of at-risk populations eligible for extended prophylaxis to choice of the most appropriate anticoagulant and definition of the ideal duration of use. This review will present the main VTE risk assessment models for hospitalized medical and surgical patients, the current recommendations for use of extended prophylaxis, and its limitations and benefits.

Resumo: Pacientes hospitalizados por doenças clínicas e cirúrgicas agudas estão sob risco de desenvolvimento de tromboembolismo venoso (TEV) durante a hospitalização e após a alta. A profilaxia farmacológica estendida além do período da hospitalização é recomendada para pacientes submetidos a cirurgias de alto risco de TEV e para grupos selecionados de pacientes clínicos hospitalizados. Diversos desafios envolvem essa prática, desde o reconhecimento das populações de risco elegíveis para a extensão da profilaxia até a escolha do anticoagulante mais adequado e a definição do tempo ideal de utilização. Os principais modelos de avaliação de risco de TEV em pacientes clínicos e cirúrgicos hospitalizados, as recomendações atuais para uso da profilaxia estendida e suas limitações e benefícios serão apresentados nesta revisão.

Keywords: clinical protocols; disease prevention; patient safety; pulmonary embolism; risk management; venous thrombosis.

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Conflict of interest statement

Conflicts of interest: MCC, ATCR, EFP and MAM receive honoraria from the pharmaceutical industry for lectures on anticoagulation.

Figures

Figure 1
Figure 1. Venous thromboembolism (VTE) prophylaxis care flow.
Figura 1
Figura 1. Fluxo de assistência na profilaxia de tromboembolismo venoso (TEV).
See this image and copyright information in PMC

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