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Risk stratification approaches for venous thromboembolism (VTE) prophylaxis in surgical patients

  • Review Article
  • Published:
Hellenic Journal of Surgery

Abstract

Aim-Background

To summarize and critically evaluate the variety of risk stratification methods for VTE prophylaxis in non-orthopaedic surgical patients.

Methods

A literature search was made using the Medline/Pubmed database.

Results

Current approaches to the stratification of patients into defined risk categories include a. Risk Assessment Models (RAMs), b. use of scoring systems and c. use of operation type. A wealth of data supports their use, although some have not undergone rigorous assessment, including external validation. An incremental risk increase in patients with a higher score supports the use of scoring systems, but similar findings have also been reported for RAMs. More complex systems have been developed in an effort to reclassify patients previously thought to be at low risk, and not in need of specific or complex thromboprophylaxis regimens. Similarly, many patients previously thought to be at moderate risk are reclassified to the high risk group.

Conclusions

The increase in VTE risk among patients with a very high risk score calls for research into methods that can effectively reduce this, not only during hospitalization or at 30 days, but for the entire three-month hazard period. Equally warranted is the head to head comparison of the various risk stratification methods, including ease of use and VTE reduction efficacy.

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Author information

Authors and Affiliations

  1. Department of Vascular Surgery, University Hospital of Patras, Patras, Greece

    S. K. Kakkos & I. A. Tsolakis

  2. Aristotelian University of Thessaloniki, Thessaloniki, Greece

    A. Katsamouris

  3. University of Cyprus, Cyprus, Greece

    A. N. Nicolaides

Authors
  1. S. K. Kakkos
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  2. I. A. Tsolakis
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  3. A. Katsamouris
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  4. A. N. Nicolaides
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Correspondence to S. K. Kakkos.

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Kakkos, S.K., Tsolakis, I.A., Katsamouris, A. et al. Risk stratification approaches for venous thromboembolism (VTE) prophylaxis in surgical patients. Hellenic J Surg 85, 18–27 (2013). https://doi.org/10.1007/s13126-013-0002-z

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  • DOI: https://doi.org/10.1007/s13126-013-0002-z

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