nach oben

World Journal of Surgery

Erschienen in:

12.06.2020 | Scientific Review

Is Extended-Duration (Post-Hospital Discharge) Venous Thromboembolism Chemoprophylaxis Safe and Efficacious in High-Risk Surgery Patients? A Systematic Review

verfasst von: Saamia Shaikh, Melanie Reddy, Mark McKenney, Adel Elkbuli

Erschienen in: World Journal of Surgery | Ausgabe 10/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

The risk of venous thromboembolism (VTE) persists beyond hospitalization in surgical patients, yet post-hospital discharge chemoprophylaxis regimens are not common. The purpose of this study is to systematically review the literature regarding extended-duration (post-hospital discharge) venous thromboembolism chemoprophylaxis and to determine whether it is warranted in high-risk surgical patients, as determined by its safety and efficacy.

Method

We searched four online databases for articles evaluating extended-duration (post-hospital discharge) VTE chemoprophylaxis regimens in surgical patients between the years January 2000 and February 2020. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used. GRADE methodology and the Cochrane Risk of Bias Assessment Tool for Randomized Controlled Trials were used to grade the quality of evidence and assess risk of bias.

Results

Nineteen studies with 10,544 patients were analyzed. The duration for extended-duration VTE chemoprophylaxis ranged from 7 to 42 days. In our study cohort, high-risk patients not prescribed extended-duration VTE chemoprophylaxis had a mean VTE incidence rate of 12.23%, while patients receiving 28–30 days of chemoprophylaxis had a mean VTE incidence rate of 4.37% (p = 0.006). The risk of bleeding events did not correlate with the duration of chemoprophylaxis.

Conclusion

Extended-duration VTE chemoprophylaxis in high-risk surgical patients decreased the incidence of thrombotic complications without increasing the risk of bleeding events. Further research is needed to establish guidelines for the optimal duration of VTE chemoprophylaxis in high-risk surgical patients.

Level of evidence

III.

Nur mit Berechtigung zugänglich

Alshouimi RA et al (2019) The use of direct oral anticoagulants for extended duration thromboprophylaxis in medically ill patients: a systematic review and meta-analysis. J Thromb Thrombolysis 48:422–429PubMed

Agnelli G, Bolis G, Capussotti L, Scarpa RM, Tonelli F, Boniz-zoni E, Moia M, Parazzini F, Rossi R, Sonaglia F, Valarani B, Bianchini C, Gussoni G (2006) A clinical outcome-based prospective study on venous thromboembolism after cancer surgery: the @RISTOS project. Ann Surg 243(1):89–95PubMedPubMedCentral

Faye AS et al (2019) Acute venous thromboembolism risk highest within 60 days after discharge from the hospital in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. https://doi.org/10.1016/j.cgh.2019.07.028CrossRefPubMedPubMedCentral

Fagarasanu A et al (2016) Role of extended thromboprophylaxis after abdominal and pelvic surgery in cancer patients: A systematic review and meta-analysis. Ann Surg Oncol 23:1422–1430PubMed

Hull RD et al (2013) Venous thromboembolism in elderly high-risk medical patients: Time course of events and influence of risk factors. Clin Appl Thromb Hemost 19(4):357–362PubMed

Wright JD, Chen L, Jorge S et al (2016) Prescription of extended-duration thromboprophylaxis after high-risk, abdominopelvic cancer surgery. Gynecol Oncol 141(3):531–537PubMedPubMedCentral

Raftopoulos I, Martindale C, Cronin A, Steinberg J (2008) The effect of extended post-discharge chemical thromboprophylaxis on venous thromboembolism rates after bariatric surgery: a prospective comparison trial. Surg Endosc 22(11):2384–2391PubMed

Eriksson BI, Lassen MR (2003) Duration of prophylaxis against venous thromboembolism with fondaparinux after hip fracture surgery. Arch Intern Med 163:1337–1342PubMed

Gilmartin CE, Cutts BA (2019) Ismail H. A cross-sectional study. Aust N Z J Obstet Gynaecol, Venous thromboembolism prophylaxis of the obese postpartum patient, pp 1–6

10.

Ruff SM (2019) Practice patterns of VTE chemoprophylaxis after discharge following hepatic and pancreatic resections for cancer: A survey of hepatopancreatobiliary surgeons. J Thromb Thrombolysis 48(1):119–124PubMedPubMedCentral

11.

Lemke M et al (2016) Patient adherence and experience with extended use of prophylactic low-molecular-weight heparin following pancreas and liver resection. J Gastrointest Surg 20:1986–1996PubMed

12.

Gould MK, Garcia DA, Wren SM et al (2012) Prevention of VTE in nonorthopedic surgical patients: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e227S–e277SPubMedPubMedCentral

13.

Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S et al (2012) Prevention of VTE in orthopedic surgery patients: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e278S–e325SPubMedPubMedCentral

14.

Zayed Y et al (2020) Extended duration of thromboprophylaxis for medically ill patients: a systematic review and meta-analysis of randomized controlled trials. Intern Med J 50(2):192–199PubMed

15.

Muñoz-Atienza V et al (2018) Extended use of bemiparin as thromboprophylaxis during bariatric surgery: results of anti-factor Xa activity measurements. Surgery for Obesity and Related Diseases 14:354–360PubMed

16.

Caprini JA (2011) Identification of patient venous thromboembolism risk across the continuum of care. Clin Appl Thromb Hemost 17:590–599PubMed

17.

Kerwin AJ, Haut ER, Burns JB, Como JJ, Haider A, Stassen N, Dahm P (2012) The Eastern Association of the Surgery of Trauma approach to practice management guideline development using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. J Trauma Acute Care Surg 73:S283–S287PubMed

18.

Guyatt G, Oxman AD, Akl EA et al (2011) GRADE guidelines: 1. Introduction and GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64:383–394PubMed

19.

Higgins JPT, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JAC (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomized trials. BMJ 343:d5928PubMedPubMedCentral

20.

Vedovati MC, Becattini C, Rondelli F et al (2014) A Randomized study on 1-week versus 4-week prophylaxis for venous thromboembolism after laparoscopic surgery for colorectal cancer. Ann Surg 259:665–669PubMed

21.

Sakon M, Kobayashi T, Shimazui T (2010) Efficacy and safety of enoxaparin in Japanese patients undergoing curative abdominal or pelvic cancer surgery: results from a multicenter, randomized, open-label study. Thromb Res 125:e65–e70PubMed

22.

Bergquivst D, Agnelli G, Cohen AT et al (2002) Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med 346:975–980

23.

Kakkar AJ, Brenner B, Dahl OE et al (2008) Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomized controlled trial. Lancet 372:31–39PubMed

24.

Kakkar VV, Balibrea JL, Martinez-Gonzales J et al (2010) Extended prophylaxis with bemiparin for the prevention of venous thromboembolism after abdominal or pelvic surgery for cancer: the CANBESURE randomized study. J Thromb Haemost 8:1223–1229PubMed

25.

Kolb G, Bodamer I, Galster H et al (2003) Reduction of venous thromboembolism following prolonged prophylaxis with the low molecular weight heparin Certoparin after endoprothetic joint replacement or osteosynthesis of the lower limb in elderly patients. Thromb Haemost 90:1100–1105PubMed

26.

Rasmussen MS, Jorgensen LN, Wille-Jorgensen P et al (2006) Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: a multicenter randomized open-label study. J Thromb Haemost 4:2384–2390PubMed

27.

Heit JA, Elliott CG, Trowbridge AA et al (2000) Ardeparin sodium for extended out-of-hospital prophylaxis against venous thromboembolism after total hip or knee replacement: a randomized, double-blind, placebo-controlled trial. Ann Int Med 132:853–861PubMed

28.

Kukreja JEB, Levey HR, Scosyrev E et al (2015) Effectiveness and safety of extended-duration prophylaxis for venous thromboembolism in major urologic oncology surgery. Urologic Oncol Semin Orig Invest 33:387.e7–387.e16

29.

Borkgren-Okonek MJ, Hart RW, Pantano JE, Rantis PC, Guske PJ, Kane JM, Gordon N, Sambol NC (2008) Enoxaparin thromboprophylaxis in gastric bypass patients: extended duration, dose stratification, and antifactor Xa activity. Surg Obes Rel Dis 4:625–631

30.

Farrow NE, Aboagye JK, Lau BD et al (2018) The role of extended/outpatient venous thromboembolism prophylaxis after abdominal surgery for cancer or inflammatory bowel disease. J Patient Safety Risk Manage 23(1):19–26

31.

Kanitra J, Holtrop J, Jawad A, Berri R (2019) Extended duration chemoprophylaxis for venous thromboembolism following abdominopelvic oncologic surgery. J Thromb Thrombolysis. https://doi.org/10.1007/s11239-019-02002-9CrossRef

32.

Cho SE, Delate T, Witt DM, Clark NP (2015) Thromboembolic and bleeding outcomes of extended duration low-intensity warfarin following elective total knee arthroplasty. Thromb Res 135:267–271PubMed

33.

Schomburg J, Krishna S, Soubra A et al (2018) Extended outpatient chemoprophylaxis reduces venous thromboembolism after radical cystectomy. Urologic Oncol Semin Orig Invest 36:77.e9–77.e13

34.

Schmeler KM, Langley G, Cain K et al (2013) Venous thromboembolism (VTE) rates following the implementation of extended duration prophylaxis for patients undergoing surgery for gynecologic malignancies. Gynecol Oncol 128(2):1–14

35.

Marino PM, Horcajo RR, Grandal TG et al (2018) Thromboprophylaxis in gynecologic cancer surgery: Is extended prophylaxis with low molecular weight heparin justified? Eur J Obstet Gynecol Reprod Biol 230:90–95

36.

Rattan R, Parreco J, Eidelson SA, Gold J, Dharmaraja A, Zakrison TL, Yeh D, Ginzburg E, Namias N (2018) Hidden burden of venous thromboembolism after trauma: A national analysis. J Trauma Acute Care Surg 85:899–906PubMed

37.

Gangireddy C, Rectenwald JR, Upchurch GR et al (2007) Risk factors and clinical impact of postoperative symptomatic venous thromboembolism. J Vasc Surg 45:335–342PubMed

38.

Huo MH, Muntz J (2009) Extended Thromboprophylaxis with low-molecular-weight heparins after hospital discharge in high-risk surgical and medical patients: a review. Clin Ther 31:1129–1141PubMed

39.

Felder S, Rasmussen MS, King R, Sklow B, Kwaan M, Madoff R, Jensen C (2019) Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery (Review). Cochrane Database Syst Rev 8:CD004318PubMed

40.

Rausa E, Kelly ME, Asti E et al (2018) Extended versus conventional thromboprophylaxis after major abdominal and pelvic surgery: systematic review and meta-analysis of randomized clinical trials. Surg 164:1234–1240

41.

Naik R, Mandal I, Hampson A et al (2019) The role of extended VTE prophylaxis for major urological cancer operations. BJU Int 124(6):935–944PubMed

42.

Forster R, Stewart M (2016) Anticoagulants (extended duration) for prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair (Review). Cochrane Database Syst Rev 3:CD004179PubMed

43.

Pow RE, Vale PR (2015) Thromboprophylaxis in patients undergoing total hip and knee arthroplasty: a review of current practices in an Australian teaching hospital. Int Med J 45(3):293–299

Titel: Is Extended-Duration (Post-Hospital Discharge) Venous Thromboembolism Chemoprophylaxis Safe and Efficacious in High-Risk Surgery Patients? A Systematic Review
verfasst von: Saamia Shaikh
Melanie Reddy
Mark McKenney
Adel Elkbuli
Publikationsdatum: 12.06.2020
Verlag: Springer International Publishing
Erschienen in: World Journal of Surgery / Ausgabe 10/2020
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05638-4

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich

weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

Background

Method

Results

Conclusion

Level of evidence

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2020

Inflammatory Risk Factors for Early Recurrence of Non-Small Cell Lung Cancer Within One Year Following Curative Resection

Preoperative Potassium Iodide Treatment in Patients Undergoing Thyroidectomy for Graves' Disease—Perspective of a European High-Volume Center

Stem Cell Marker Expression in Early Stage Colorectal Cancer is Associated with Recurrent Intestinal Neoplasia

Provider–patient Language Discordance and Cancer Operations: Outcomes from a Single Center Linked to a State Vital Statistics Registry

What to Propose After Failed Adjustable Gastric Banding: One- or Two-step Procedure?

Commentary: Parental Leave Policies: Have We Come a Long Way, Baby?

Neu im Fachgebiet Chirurgie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Hinter dieser Appendizitis steckte ein Erreger

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

Ureterstriktur: Innovative OP-Technik bewährt sich

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“