ABSTRACT

Despite effective means of DVT prophylaxis being available for surgical and medically ill patients, PE remains the most common preventable cause of death in hospitalized patients. The risk of a venous thromboembolic event occurring after surgery in patients not receiving prophylaxis is summarized in Table 3.1. While the rates recorded in Table 3.1 are from studies reported 12 to 20 or more years ago, and operative techniques have improved along with patient ambulation, resulting in potentially lower inherent rates of postoperative DVT, fatal PE continues to be a major but preventable postoperative complication. Although fatal PE is recognized after surgical procedures and 10% of all hospital deaths are due to PE, VTE in hospitalized patients is not only a surgical problem.4 Fifty to seventy percent of symptomatic venous thromboembolic events and 70% to 80% of fatal PEs occur in medical patients.5 In a prospective study of medical ICU patients, DVT was detected by venous ultrasound in 33%.6