Studies utilizing venography and fibrinogen uptake test have shown the incidence of deep venous thrombosis (DVT) to be up to 25%. 10, 11 The majority of patients who develop perioperative VTE are asymptomatic thus, it is difficult to assess the actual incidence. The Centers for Medicare and Medicaid Services (CMS) considers VTE in hospitalized patients a “never event,” which is pegged to the “pay for performance” initiative. 2, 3, 4, 5, 6, 7, 8, 9 Prevention of postoperative VTE is considered a quality and patient-safety measure in most mandated quality-improvement initiatives. 1 Pulmonary embolism (PE) is recognized as the most common cause of preventable hospital deaths, accounting for up to 200,000 deaths annually in the United States. The risk of VTE is estimated to be 20% for general surgical patients and 30% for patients undergoing colorectal procedures. Venous thromboembolism (VTE) is common after major general surgery. Objectives: On completion of this article, the reader should be able to determine risks profiles for venous thromboembolism and pulmonary embolism in patients undergoing colon and rectal surgery, and to discuss the benefits of mechanical and pharmacologic venous thromboembolism prophylaxis. The type of prophylaxis should be commensurate with the risk of VTE based on the composite risk profile. Patients undergoing surgery should be stratified according to their risk of VTE based on patient risk factors, disease-related risk factors, and procedure-related risk factors. A combination of mechanical and pharmacologic methods produces the best results. The measures for prevention of VTE include mechanical methods (graduated compression stockings and intermittent pneumatic compression devices) and pharmacologic agents. Prevention of VTE is considered a patient-safety measure in most mandated quality initiatives. The incidence of venous thromboembolism in this population is estimated to be 0.2 to 0.3%. The risk of deep venous thrombosis (DVT) and pulmonary embolism (PE) is higher in colorectal surgical procedures compared with general surgical procedures. Pulmonary embolism is recognized as the most common identifiable cause of death in hospitalized patients in the United States. Venous thromboembolism (VTE) can occur after major general surgery.
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