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Deep Vein Thrombosis and Pulmonary Embolism in the Operating Room

Practice Essentials

Colloquially known as blood clots, deep vein thrombosis (DVT) and pulmonary embolism (PE) are forms of venous thromboembolism (VTE). VTE events are common both inside and outside the operating room (OR) and are associated with increased morbidity and mortality.
 With approximately 600,000 total cases diagnosed and as many as 100,000 deaths per year, VTE is a significant factor in all-cause disability, morbidity, and mortality in the general population.

In population-based studies, the incidence of DVT has been reported as ranging from 43.7 to 145 per 100,000, whereas that of PE has ranged from 20.8 to 65.8 per 100,000. Overall, VTE is more common in older males and females than in their younger counterparts; in particular, VTE rates are higher in males older than 45 years. A notable exception to this is the slightly higher incidence of VTE noted in females in their reproductive years, a large part of which is attributable to oral contraceptive use.

In an effort to reduce VTE-associated morbidity and mortality, considerable emphasis is now being placed on primary prevention. Efforts by The Joint Commission (JC) have been aimed at developing standardized approaches to VTE prophylaxis, with the institution of the Surgical Care Improvement Project (SCIP) measures. Preventive measures include requiring hospitals to institute VTE prophylaxis 24 hours before and after surgery in appropriate patient populations.

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