Many Surgical Patients Might Not Need Pharmacologic VTE Prophylaxis

Postoperative venous thromboembolism (VTE) accounts for >50% of VTEs among U.S. patients. Meta-analysis data suggests that only patients at highest risk (as determined by the Caprini risk assessment tool) benefit from postoperative pharmacologic VTE prophylaxis (Ann Surg 2017; 265:1094). However, the U.S. Centers for Medicare & Medicaid Services use postoperative VTE episodes as a quality measure, which prompts many clinicians and hospitals to prescribe postop pharmacologic VTE prophylaxis broadly.

In a retrospective cohort study, Michigan investigators used a statewide collaborative of 63 hospitals to identify symptomatic postoperative VTEs among nonorthopedic surgical patients who received (≈22,000 patients) or did not receive (≈11,000 pat…