TY - JOUR
T1 - American Society of Hematology 2019 guidelines for management of venous thromboembolism
T2 - Prevention of venous thromboembolism in surgical hospitalized patients
AU - Anderson, David R.
AU - Morgano, Gian Paolo
AU - Bennett, Carole
AU - Dentali, Francesco
AU - Francis, Charles W.
AU - Garcia, David A.
AU - Kahn, Susan R.
AU - Rahman, Maryam
AU - Rajasekhar, Anita
AU - Rogers, Frederick B.
AU - Smythe, Maureen A.
AU - Tikkinen, Kari A.O.
AU - Yates, Adolph J.
AU - Baldeh, Tejan
AU - Balduzzi, Sara
AU - Brozek, Jan L.
AU - Etxeandia-Ikobaltzeta, Itziar
AU - Johal, Herman
AU - Neumann, Ignacio
AU - Wiercioch, Wojtek
AU - Yepes-Nunez, Juan José
AU - Schünemann, Holger J.
AU - Dahm, Philipp
N1 - Publisher Copyright:
© 2019 American Society of Hematology. All rights reserved.
PY - 2019
Y1 - 2019
N2 - 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 5 8), orthopedic surgery (n 5 7), major general surgery (n 5 3), major neurosurgical procedures (n 5 2), urological surgery (n 5 4), cardiac surgery and major vascular surgery (n 5 2), major trauma (n 5 2), and major gynecological surgery (n 5 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.
AB - 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 5 8), orthopedic surgery (n 5 7), major general surgery (n 5 3), major neurosurgical procedures (n 5 2), urological surgery (n 5 4), cardiac surgery and major vascular surgery (n 5 2), major trauma (n 5 2), and major gynecological surgery (n 5 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.
UR - https://www.scopus.com/pages/publications/85076375048
U2 - 10.1182/bloodadvances.2019000975
DO - 10.1182/bloodadvances.2019000975
M3 - Article
C2 - 31794602
AN - SCOPUS:85076375048
SN - 2473-9529
VL - 3
SP - 3898
EP - 3944
JO - Blood Advances
JF - Blood Advances
IS - 23
ER -