Why the study?
Perioperative thromboprophylaxis guidelines provide conflicting recommendations on when to initiate prophylaxis, leading to clinical practice variation that may worsen patient outcomes.
Does preoperative initiation of pharmacologic thromboprophylaxis reduce venous thromboembolism and bleeding in patients undergoing surgery compared to postoperative initiation?
Population
17,124 surgical patients across 22 randomized controlled trials
Comparison
Pharmacologic thromboprophylaxis initiated preoperatively vs postoperatively
Design
Systematic review and meta-analysis of randomized controlled trials
Authors
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No significant VTE or bleeding difference by start timing supports flexible perioperative decisions; leaves optimal initiation unresolved.
Does preoperative initiation of pharmacologic thromboprophylaxis reduce venous thromboembolism and bleeding in patients undergoing surgery compared to postoperative initiation?
Preoperative initiation of pharmacologic thromboprophylaxis shows a non-significant trend toward reduced VTE and increased bleeding compared to postoperative initiation.
McAlpine et al. (2021) studied this question.
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