Key result
Low molecular weight heparins and direct oral anticoagulants are the principal modalities for venous thromboembolism prophylaxis in inpatient rehabilitation, as mobilization alone is insufficient.
Why the study?
There is a paucity of high-quality evidence specific to patients in the rehabilitation setting and no clinical practice guidelines that provide thromboprophylaxis recommendations across the broad spectrum of rehabilitation patients.
What are the optimal approaches to venous thromboembolism prophylaxis in patients in the rehabilitation setting?
What are the optimal approaches to venous thromboembolism prophylaxis in patients in the rehabilitation setting?
This review provides evidence-informed practice suggestions for venous thromboembolism prophylaxis in inpatient rehabilitation, highlighting the need for pharmacological prophylaxis beyond mobilization alone.
Venous thromboembolism is a frequent complication of acute hospital care, and this extends to inpatient rehabilitation. The timely use of appropriate thromboprophylaxis in patients who are at risk is a strong, evidence-based patient safety priority that has reduced clinically important venous thromboembolism, associated mortality and costs of care. While there has been extensive research on optimal approaches to venous thromboembolism prophylaxis in acute care, there is a paucity of high-quality evidence specific to patients in the rehabilitation setting, and there are no clinical practice guidelines that make recommendations for (or against) thromboprophylaxis across the broad spectrum of rehabilitation patients. Herein, we provide an evidence-informed review of the topic with practice suggestions. We conducted a series of literature searches to assess the risks of venous thromboembolism and its prevention related to inpatient rehabilitation as well as in major rehabilitation subgroups. Mobilization alone does not eliminate the risk of venous thromboembolism after another thrombotic insult. Low molecular weight heparins and direct oral anticoagulants are the principal current modalities of thromboprophylaxis. Based on the literature, we make suggestions for venous thromboembolism prevention and include an approach for consideration by rehabilitation units that can be aligned with local practice.
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Geerts et al. (2024) conducted a review in Venous thromboembolism in inpatient rehabilitation. Thromboprophylaxis (Low molecular weight heparins and direct oral anticoagulants) was evaluated. Low molecular weight heparins and direct oral anticoagulants are the principal modalities for venous thromboembolism prophylaxis in inpatient rehabilitation, as mobilization alone is insufficient.
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