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

被引：412

作者：

Anderson, David R. ^{[1
]}

Morgano, Gian Paolo ^{[2
]}

Bennett, Carole

Dentali, Francesco ^{[3
]}

Francis, Charles W. ^{[4
]}

Garcia, David A. ^{[5
]}

Kahn, Susan R. ^{[6
,7
]}

Rahman, Maryam ^{[8
]}

Rajasekhar, Anita ^{[9
]}

Rogers, Frederick B. ^{[10
]}

Smythe, Maureen A. ^{[11
,12
]}

Tikkinen, Kari A. O. ^{[13
,14
,15
]}

Yates, Adolph J. ^{[16
]}

Baldeh, Tejan ^{[2
]}

Balduzzi, Sara ^{[17
]}

Brozek, Jan L. ^{[2
,18
]}

Etxeandia-Ikobaltzeta, Itziar ^{[2
]}

Johal, Herman ^{[19
]}

Neumann, Ignacio ^{[20
]}

Wiercioch, Wojtek ^{[2
]}

Jose Yepes-Nunez, Juan ^{[21
]}

Schunemann, Holger J. ^{[2
,18
]}

Dahm, Philipp ^{[22
,23
]}

机构：

[1] Dalhousie Univ, Dept Med, Halifax, NS, Canada

[2] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[3] Insubria Univ, Dept Med & Surg, Varese, Italy

[4] Univ Rochester, Med Ctr, Wilmot Canc Ctr, Rochester, NY 14642 USA

[5] Univ Washington, Sch Med, Dept Med, Med Ctr,Div Hematol, Seattle, WA 98195 USA

[6] McGill Univ, Dept Med, Montreal, PQ, Canada

[7] Lady Davis Inst, Montreal, PQ, Canada

[8] Univ Florida, Lillian S Wells Dept Neurosurg, Gainesville, FL USA

[9] Univ Florida, Dept Med, Div Hematol & Oncol, Gainesville, FL USA

[10] Penn Med Lancaster Gen Hlth, Trauma & Acute Care Surg, Lancaster, PA USA

[11] Beaumont Hosp, Dept Pharmaceut Serv, Royal Oak, MI USA

[12] Wayne State Univ, Dept Pharm Practice, Detroit, MI USA

[13] Univ Helsinki, Dept Urol, Helsinki, Finland

[14] Univ Helsinki, Dept Publ Hlth, Helsinki, Finland

[15] Helsinki Univ Hosp, Helsinki, Finland

[16] Univ Pittsburgh, Med Ctr, Dept Orthoped Surg, Pittsburgh, PA USA

[17] Univ Modena & Reggio Emilia, Dept Diagnost Clin & Publ Hlth Med, Modena, Italy

[18] McMaster Univ, Dept Med, Hamilton, ON, Canada

[19] McMaster Univ, Ctr Evidence Based Orthopaed, Div Orthopaed Surg, Hamilton, ON, Canada

[20] Pontificia Univ Catolica Chile, Dept Internal Med, Sch Med, Santiago, Chile

[21] Univ Andes, Sch Med, Bogota, Colombia

[22] Minneapolis VA Hlth Care Syst, Urol Sect, Minneapolis, MN USA

[23] Univ Minnesota, Dept Urol, Minneapolis, MN USA

来源：

BLOOD ADVANCES | 2019年 / 3卷 / 23期

关键词：

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;

D O I：

10.1182/bloodadvances.2019000975

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：3898 / 3944

页数：47

共 419 条

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