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Type: Journal article
Title: Evidence-based risk factors for postoperative deep vein thrombosis
Author: Edmonds, M.
Crichton, T.
Runciman, W.
Pradhan, M.
Citation: Australian and New Zealand Journal of Surgery, 2004; 74(12):1082-1097
Publisher: Blackwell Science Asia
Issue Date: 2004
ISSN: 1445-1433
Statement of
M. J. R. Edmonds, T. J. H. Crichton, W. B. Runciman and M. Pradhan
Abstract: BACKGROUND: Deep vein thrombosis (DVT) is a common postoperative complication that is associated with significant morbidity and mortality. Thromboprophylaxis has been shown to be underused. In the absence of prophylaxis, rates as high as 50% have been reported following orthopaedic surgery, and 25% following general surgery. Many risk factors have been suggested but there is often little evidence to support these claims. METHODS: A systematic review was performed to determine the evidence base behind each suggested risk factor, and, where sufficient data were available, a random-effects meta-analysis was performed. RESULTS: There is evidence to support a significant association between increased age, obesity, a past history of thromboembolism, varicose veins, the oral contraceptive pill, malignancy, Factor V Leiden gene mutation, general anaesthesia and orthopaedic surgery, with higher rates of postoperative DVT, although there remain some variables within the study designs that may lead to overestimation of effect. There is no evidence to support the suggested risk factors of hormone replacement therapy, gender, ethnicity or race, chemotherapy, other thrombophilias, cardiovascular factors, smoking and blood type. CONCLUSIONS: An accurate knowledge of evidence-based risk factors is important in predicting and preventing postoperative DVT, and can be incorporated into a decision support system for appropriate thromboprophylaxis use.
Keywords: Evidence-based medicine; postoperative complications; risk assessment; risk factors; venous thrombosis
Description: The definitive version is available at
RMID: 0020041965
DOI: 10.1111/j.1445-1433.2004.03258.x
Appears in Collections:Anaesthesia and Intensive Care publications

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