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May 5, 1988New England Journal of Medicine

Reduction in Fatal Pulmonary Embolism and Venous Thrombosis by Perioperative Administration of Subcutaneous Heparin

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Why the study?

Does perioperative administration of subcutaneous heparin reduce fatal pulmonary embolism and venous thrombosis in surgical patients?

Population

Patients undergoing general surgery or orthopedic surgery

Authors

RCRory CollinsASAlison ScrimgeourSYSalim Yusuf

Discussion

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Overview

Efficacy of perioperative subcutaneous heparin for fatal PE and VTE remains unproven; leaves open need for definitive trials before practice change.

Key Points

  • To evaluate whether perioperative subcutaneous heparin administration reduces deep-vein thrombosis and fatal pulmonary embolism in patients undergoing surgery.
  • Monitored patients undergoing prolonged general anesthesia and postoperative immobilization across general and orthopedic surgical settings.
  • Tracked deep-vein thrombosis formation using radiolabeled fibrinogen scanning and venography.
  • Deep-vein thrombosis occurred in 20% to 30% of general surgery patients and an even higher percentage of orthopedic surgery patients without intervention.
  • Perioperative administration of subcutaneous heparin significantly lowers the incidence of venous thrombosis and fatal pulmonary embolism.

Structured PICO

Does perioperative administration of subcutaneous heparin reduce fatal pulmonary embolism and venous thrombosis in surgical patients?

P
Population
Patients undergoing general surgery or orthopedic surgery
I
Intervention
Perioperative administration of subcutaneous heparin
O
Outcome
Fatal pulmonary embolism and venous thrombosishard clinical

Perioperative administration of subcutaneous heparin is investigated for the reduction of fatal pulmonary embolism and venous thrombosis.

Cite This Study

Collins et al. (1988) studied this question.

synapsesocial.com/papers/69dd13dc0de68e8319e53dfchttps://doi.org/10.1056/nejm198805053181805
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparison of Postoperative Coumarin, Dextran 40 and Subcutaneous Heparin in the Prevention of Postoperative Deep Vein Thrombosis1977 · 9 citations
  2. 2Low-Dose Heparin in Proximal Femoral Fractures:Failure to Prevent Deep-Vein Thrombosis1981 · 14 citations
  3. 3Deep Vein Thrombosis Following Hip Surgery:Relation to Activated Factor X Inhibitor Activity: Effect of Heparin and Dextran1982 · 13 citations
  4. 4Aspirin Prophylaxis of Venous Thromboembolism after Total Hip Replacement1977 · 344 citations
  5. 5Oral anticoagulants controlled by the British comparative thromboplastin versus low-dose heparin in prophylaxis of deep vein thrombosis1978 · 156 citations