American Society of Hematology 2019 guidelines for management of venous thromboembolism : prevention of venous thromboembolism in surgical hospitalized patients

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Anderson , D R , Morgano , G P , Bennett , C , Dentali , F , Francis , C W , Garcia , D A , Kahn , S R , Rahman , M , Rajasekhar , A , Rogers , F B , Smythe , M A , Tikkinen , K A O , Yates , A J , Baldeh , T , Balduzzi , S , Brozek , J L , Etxeandia-Ikobaltzeta , I , Johal , H , Neumann , I , Wiercioch , W , Jose Yepes-Nunez , J , Schunemann , H J & Dahm , P 2019 , ' American Society of Hematology 2019 guidelines for management of venous thromboembolism : prevention of venous thromboembolism in surgical hospitalized patients ' , Blood advances , vol. 3 , no. 23 , pp. 3898-3944 . https://doi.org/10.1182/bloodadvances.2019000975

Title: American Society of Hematology 2019 guidelines for management of venous thromboembolism : prevention of venous thromboembolism in surgical hospitalized patients
Author: Anderson, David R.; Morgano, Gian Paolo; Bennett, Carole; Dentali, Francesco; Francis, Charles W.; Garcia, David A.; Kahn, Susan R.; Rahman, Maryam; Rajasekhar, Anita; Rogers, Frederick B.; Smythe, Maureen A.; Tikkinen, Kari A. O.; Yates, Adolph J.; Baldeh, Tejan; Balduzzi, Sara; Brozek, Jan L.; Etxeandia-Ikobaltzeta, Itziar; Johal, Herman; Neumann, Ignacio; Wiercioch, Wojtek; Jose Yepes-Nunez, Juan; Schunemann, Holger J.; Dahm, Philipp
Other contributor: University of Helsinki, HUS Abdominal Center





Date: 2019-12-10
Language: eng
Number of pages: 47
Belongs to series: Blood advances
ISSN: 2473-9529
DOI: https://doi.org/10.1182/bloodadvances.2019000975
URI: http://hdl.handle.net/10138/309691
Abstract: Background: Venous thromboembolism (VTE) is a common source of perioperative morbidity and mortality. Objective: These evidence-based guidelines from the American Society of Hematology (ASH) intend to support decision making about preventing VTE in patients undergoing surgery. Methods: ASH formed a multidisciplinary guideline panel balanced to minimize bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline-development process, including performing systematic reviews. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 30 recommendations, including for major surgery in general (n = 8), orthopedic surgery (n = 7), major general surgery (n = 3), major neurosurgical procedures (n = 2), urological surgery (n = 4), cardiac surgery and major vascular surgery (n = 2), major trauma (n = 2), and major gynecological surgery (n = 2). Conclusions: For patients undergoing major surgery in general, the panel made conditional recommendations for mechanical prophylaxis over no prophylaxis, for pneumatic compression prophylaxis over graduated compression stockings, and against inferior vena cava filters. In patients undergoing total hip or total knee arthroplasty, conditional recommendations included using either aspirin or anticoagulants, as well as for a direct oral anticoagulant over low-molecular-weight heparin (LMWH). For major general surgery, the panel suggested pharmacological prophylaxis over no prophylaxis, using LMWH or unfractionated heparin. For major neurosurgery, transurethral resection of the prostate, or radical prostatectomy, the panel suggested against pharmacological prophylaxis. For major trauma surgery or major gynecological surgery, the panel suggested pharmacological prophylaxis over no prophylaxis.
Subject: LOW-MOLECULAR-WEIGHT
DEEP-VEIN-THROMBOSIS
LOW-DOSE HEPARIN
TOTAL HIP-REPLACEMENT
INTERMITTENT PNEUMATIC COMPRESSION
FACTOR-XA INHIBITOR
VENA-CAVA FILTER
TOTAL KNEE REPLACEMENT
RANDOMIZED CONTROLLED-TRIAL
MAJOR ABDOMINAL-SURGERY
3126 Surgery, anesthesiology, intensive care, radiology
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