A Comparative Review of Major International Guidelines for Venous Thromboembolism Prophylaxis in Gynecology.

STUDY

OBJECTIVE

Perioperative venous thromboembolism (VTE) remains a leading cause of preventable morbidity in the perioperative period. Despite evidence-based guidelines, significant practice variations exist globally. The aim of this study was to compare major international guidelines for VTE prophylaxis in gynecologic surgery.

DESIGN

Guidelines from the American College of Obstetricians and Gynecologists, the American College of Chest Physicians, American Society of Clinical Oncology, National Institute for Health and Care Excellence in the United Kingdom, National Health and Medical Research Council of Australia, Society of Obstetrician and Gynecologists of Canada, Federation of Columbian Obstetrics and Gynecology, and the German G3 Society were reviewed.

INTERVENTIONS: A comprehensive literature search was conducted using PubMed, Scopus and Embase to search for a major international guideline related to VTE prophylaxis in gynecological surgery.

MEASUREMENT AND MAIN

RESULTS

Most international guidelines support the use of a risk assessment model (RAM), such as the Caprini score. There is broad consensus on the use of pharmacologic and mechanical prophylaxis for moderate- to high-risk patients and for extended prophylaxis in cancer-related surgeries. However, guidelines inconsistently address other aspects of VTE prophylaxis such as, timing of pre- and postoperative prophylaxis, use in minimally invasive surgery, and management of same-day discharge cases.

CONCLUSION

Establishing consistent international guidelines for VTE prophylaxis is essential to help providers worldwide prevent a potentially fatal complication following gynecologic surgery. Further research is needed to standardize best practices and support their incorporation into guidelines.