Emergency general surgery patients treated surgically and nonsurgically face a high risk of developing venous thromboembolism, according to a study published in JAMA Surgery.
Researchers reviewed Medline, Embase and the Cochrane Database of Collected Reviews from Jan. 1, 1990, through Dec. 31, 2015. They identified randomized clinical trials, meta-analyses, systematic reviews and observational studies involving VTE.
Compared with elective surgical patients, operatively treated emergency general surgery patients are at an increased risk of VTE. The risk varies based on the underlying diagnosis, from 0.2 percent for appendectomy patients to 4 percent for colectomy patients, in addition to patient-specific factors.
Additionally, the study shows patients should receive the first dose of VTE prophylaxis at admission to the hospital and administration should continue until discharge without missed doses. Mechanical prophylaxis should be considered in all patients.
"Studies that specifically target improved adherence with VTE prophylaxis in EGS patients suggest that efficacy and quality improvement initiatives should be undertaken from a system and institutional perspective," study authors noted.