Thrombosis prevention

Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

Overview
Thrombosis and embolism can be partially prevented with anticoagulants in those deemed at risk. Generally, a risk-benefit analysis is required, as all anticoagulants increase the risk of bleeding. In atrial fibrillation, for instance, the risk of stroke (calculated on the basis of additional risk factors, such as advanced age and high blood pressure) outweigh the risk of bleeding associated with warfarin use.

In-hospital patients, thrombosis is a major cause for complications and is occasionally fatal. In 2005,a Parliamentary Health Select Committee in UK, stated that the annual rate of death due to hospital-acquired thrombosis was 25,000.

In patients admitted for surgery, compression stockings are widely used. In severe illness, prolonged immobility and in all orthopedic surgery, professional guidelines recommend
 * low molecular weight heparin administration
 * mechanical calf compression
 * vena cava filter (if LMWH or mechanical compression is contraindicated and the patient has recently suffered deep vein thrombosis).

In patients with medical rather than surgical illness, LMWH is known to prevent thrombosis,

In United Kingdom, the Chief Medical Officer has issued guidelines that preventative measures should be used in patients, in anticipation of formal guidelines.