Key result
Surgical thromboprophylaxis requires improved, standardized algorithms for high-risk patients with comorbid pathologies.
Why the study?
Despite existing clinical recommendations, the incidence of venous thromboembolic complications remains high, and the effectiveness of various prophylaxis approaches in patients with comorbidities is debated.
Current thromboprophylaxis may fall short in high-risk comorbid surgical patients; leaves open refined algorithms pending prospective validation.
INTRODUCTION: Venous thromboembolic complications (VTEC) such as deep and subcutaneous vein thrombosis and pulmonary embolism are the most important clinical problems in many specialties. High-risk factors for thrombus formation include surgical interventions leading to the activation of the hemostatic system. Despite the existing international and Russian clinical recommendations on the treatment and prophylaxis of VTEC containing a detailed description of the methods and algorithms of prophylaxis in patients with different nosologies including patients with polymorbidities, the incidence of VTEC remains high. In the scientific community, there is a continuing discussion of the effectiveness of various approaches to VTEC prophylaxis in different clinical groups of patients. Algorithms available prescribe anticoagulants at standard doses and combinations. However, in patients with comorbidities, isolated conservative anticoagulant therapy may be insufficient for effective VTEC prophylaxis. CONCLUSION: Currently, there is a need to improve the algorithms of VTEC prophylaxis in patients with comorbid pathologies to elaborate clear indications for the use of both pharmacological and mechanical prevention methods and their combinations.
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Katelnitskiy et al. (2022) conducted a review in Venous thromboembolic complications in high-risk surgical patients. Thromboprophylaxis (pharmacological and mechanical) was evaluated. Pharmacological and mechanical thromboprophylaxis methods require improved algorithms and clear indications for use and combination in high-risk surgical patients with comorbid pathologies.
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