DVT & PE after surgery. The “not-so-silent” killer
Posted in Lectures on 18 July 2019
Dr. Carolina González-Abós
Department of Gastrointestinal Surgery
Hospital Clínic Barcelona
Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE) is one of the most common preventable causes of death following surgery.
The Caprini score is used to assess the Venous thromboembolism risk of each surgery.
Usually a score of 3 and 4 indicates moderate risk and a score of 5 or higher indicates high risk.Thromboprophylaxis must be used in patients undergoing surgery who are at moderate or high risk of thrombosis.Mechanical prophylaxis is indicated in patients with low risk of bleeding.
Pharmacologic prophylaxis is suggested in moderate-risk patients and recommended in high-risk patients.An individualized decision must be made for each patient.Cancer patients and bariatric patients, among others, are at a higher risk of thrombosis. We must think about deep venous thrombosis when the patient presents with pain in the posterior part of the leg, swelling and positive Homans’ sign.By contrast, pulmonary embolism usually displays these clinical manifestations:
Acute dyspnea or loss of consciousness, Desaturation, Chest pain, Tachycardia, Typical EKG manifestations.