Key result
Prolonged thromboprophylaxis with low molecular weight heparin for at least 14 days after abdominal or pelvic surgery reduced the incidence of overall VTE from 13.2% to 5.3%.
Why the study?
Major abdominal and pelvic surgery carries a high risk of VTE, and while in-hospital LMWH thromboprophylaxis is well-documented, the optimal duration after surgery remains controversial.
Does prolonged thromboprophylaxis with low molecular weight heparin reduce venous thromboembolism in patients undergoing major abdominal and pelvic surgery?
Systematic Review (n=1,728)
Does prolonged thromboprophylaxis with low molecular weight heparin reduce venous thromboembolism in patients undergoing major abdominal and pelvic surgery?
Prolonged thromboprophylaxis with LMWH up to 28 days after major abdominopelvic surgery may reduce the risk of venous thromboembolism.
Answers are grounded in this paper and cite their sources.
Supports extended LMWH prophylaxis after abdominopelvic surgery; reinforces Level 1 evidence for guideline-directed VTE prevention.
This an update of the review first published in 2009.Major abdominal and pelvic surgery carries a high risk of venous thromboembolism (VTE). The efficacy of thromboprophylaxis with low molecular weight heparin (LMWH) administered during the in-hospital period is well-documented, but the optimal duration of prophylaxis after surgery remains controversial. Some studies suggest that patients undergoing major abdominopelvic surgery benefit from prolongation of the prophylaxis up to 28 days after surgery.
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Felder et al. (2019) conducted a systematic review in Abdominal or pelvic surgery (n=1,728). Low molecular weight heparin (LMWH) vs. In-hospital thromboprophylaxis only (followed by placebo or no treatment) was evaluated on Incidence of overall VTE within 30 days after surgery (OR 0.38, 95% CI 0.26 to 0.54). Prolonged thromboprophylaxis with low molecular weight heparin for at least 14 days after abdominal or pelvic surgery reduced the incidence of overall VTE from 13.2% to 5.3%.
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