Best Practices in Preventing Deep Vein Thrombosis and Pulmonary Embolism
In surgery, the risks of venous thromboembolism have been defined and quantified, and the ability to lessen the problem by use of prophylactic measures has been shown in a number of studies. While an individual surgeon may claim to never have known a case of postoperative PE, the statistics prove that this is a problem that is far greater than is generally realized. Often, cases of late fatal PE escape detection, as sudden death at home could be attributed to some other cause. After a patient is discharged from the hospital, a postoperative DVT may go unnoticed by the surgeon, as it is quite likely the patient will be diagnosed and treated by a primary care physician. Even patients who die in the hospital shortly after surgery may not be considered as victims of PE if there has not been a thorough autopsy to establish the cause of death conclusively.
Before any operation, a surgeon is required to weigh the benefits of surgery against the potential risks to the patient. By understanding which types of patients are at risk of venous thromboembolism and why, the surgeon will be able to make the best and most rational use of the currently available forms of prophylaxis, thereby ensuring that the surgery leads to a true improvement in quality of life for the patient.
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