heparin, can cost up
to $500 for 30-day
preventative doses,
but studies have
shown that they can
reduce the risk of
VTE in higher risk
patients. One such
study, published in
the Current
Opinion on
Pulmonary
Medicine, found the
risk of a fatal pulmonary embolism reduced by 62% in patients who
underwent prophylaxis with low-dose anticoagulants. The same
study found the risk for symptomatic DVT reduced by 53%.
However, there's still some debate surrounding the use of anticoagu-
lant prophylaxis, due largely to concerns about patient bleeding.
While it's true that anticoagulants can lead to bleeding, no one dies
from receiving preventative doses of anticoagulants.
Risks of overtreatment
On the other hand, beware of the risk of overtreating. Three-fourths of
surgical patients might be receiving anti-clotting medications they don't
need, according to research my colleagues and I published in the
Annals of Surgery (osmag.net/UFjyF3). We concluded that the benefit
of perioperative venous thromboembolism chemoprophylaxis was only
found among surgical patients with Caprini scores ≥7. Precision medi-
cine using individualized VTE risk stratification helps ensure that
J A n U A R Y 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 6 7
AT RISK Compression stockings help prevent thrombosis in at-risk patients.
