Prediction of venous thromboembolism after surgery for colorectal cancer: a prevention paradigm

SUMMARY Colorectal cancer patients are at elevated risk for venous thromboembolism, especially in the postsurgical setting. Many risk factors particular to colorectal patients have been identified including malignancy-associated hypercoagulability, colorectal cancer in its own right, chemotherapy, obesity and operative approach. While initiatives aimed at improving inpatient prophylaxis have been effective, the period of risk extends far beyond the inpatient episode suggesting that this approach is inadequate. The prolonged hypercoaguable state combined with the efficacy of extended-duration thromboprophylaxis has led to international consensus guidelines suggesting its implementation. International compliance is low, highlighting the need for greater educational efforts. Risk stratification using identified predictors of venous thromboembolism may improve guideline delivery through a more targeted approach.