Venous thromboembolism (VTE) signifies the most preventable reason of morbidity and mortality in hospitalized patients. Emergency general surgery patients are at augmented risk of morbidity and mortality because of the nature of acute surgical conditions and the challenges related to prophylaxis.

Pharmacologic prophylaxis in the form of low-molecular-weight or unfractionated heparin must be considered unless an utter contraindication, such as bleeding, exists. Certain patient with malignant tumors, can get benefit from prolonged VTE prophylaxis after discharge. Mechanical prophylaxis must be well-thought-out in all patients, principally if pharmacologic prophylaxis is contraindicated. Operatively and nonoperatively treated EGS patients are at a comparatively high risk of VTE.

Improved recognition of the relatively higher VTE risk in EGS patients is necessary to recover patient safety. Many causes, together with the patient’s disease progression and the complication of coordinated care, make EGS patients a thought-provoking group to provide adequate VTE prophylaxis.

Various institutions are commencing to identify the need for prospective measurement and improving the culture of safety at the individual and institutional. A validated system for risk assessment and prescribing LMWH is recommend, using for all operative and nonoperative EGS admissions and mechanical prophylaxis if pharmacologic prophylaxis is contraindicated.

Source: JAMA Surg. 2018;153(5):479-486