Surgery

Surgery, the intervention itself and the limited mobility during the postoperative period, is a risk factor for thrombosis and pulmonary embolism

VTE and surgery are closely related. In Spain, one in every 7 patients who is diagnosed with DVT or PE, has undergone surgery in the weeks prior to the diagnosis of the disease.

This is basically due to the limited mobility that the convalescent person has during the postoperative period. Blood circulation in the veins  slows down and, thus it is more prone to cause thrombosis. In addition, in post-surgical patients, there is a tendency of the blood to clot more easily, as part of the body’s response to the intervention.

Orthopedic surgery procedures , hip or knee replacement, femur fractures and the like, are the ones that are most frequently accompanied by DVT  ( VTE – your choice, again), comprising 30% of the cases followed by cancer (15%), digestive (13%), genitourinary (10%), and  brain surgery (less than 10%).

The risk  does not only depend on the type of procedure, its duration and the anesthetic, but also on the patient’s condition before surgery. High-risk patients receive daily injections of low molecular weight heparin to prevent thrombosis. Recently, new oral anticoagulants have been used for the same purpose.

Newly operated patients are urged to get out of bed and walk about ASAP to avoid developing  VTE.

Patients need to be aware of how important physical activity is, so that they will keep up the good habit of walking once at home to prevent VTE.

VTE CALCULATED RISK BY TYPE OF SURGERY

 

In this graph you can see, in real time with RIETE registry data, the risk of VTE (percentage) with different variables related to surgery

 

RELATED QUESTIONS

My husband has been wearing a knee prosthesis for 10 days. He has not taken his anticoagulants and now his leg hurts. Could this be the reason?

If the pain is in the knee, most likely the pain is related to surgery. However, if the leg under the knee hurts (and swells), thrombosis is the most likely cause. First, you need to find out what causes the pain. Ask your doctor. Depending on the diagnosis, anticoagulants will be needed to  or not.

My father underwent surgery because of a hernia and he did not receive heparin. He then died of a pulmonary embolism. Was this a case of medical negligence?

Not necessarily. As a consequence of a surgical procedure some patients bleed (during the intervention or during the first days) and in others, blood gets thicker and promotes the creation of clots (thrombi). If we give heparin, we reduce the risk of thrombosis, but we increase the risk of bleeding.

Every case is different. Nobody can know which patients will bleed and which will develop a thrombosis (with or without heparin). The decision to prescribe heparin or not, is based on approximations. Some procedures bleed a lot and create very few thrombi, other procedures bleed very little and cause many thromboses, while others bleed a lot and create many thromboses.

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Do you have any questions?

If there are any aspects of thrombosis and/or pulmonary embolism that you are not sure about, you can contact us, and our specialists will answer you shortly. This cannot replace the visit to your doctor

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