PMID- 28901992
OWN - NLM
STAT- MEDLINE
DCOM- 20190923
LR  - 20190923
IS  - 1365-2346 (Electronic)
IS  - 0265-0215 (Linking)
VI  - 35
IP  - 2
DP  - 2018 Feb
TI  - European guidelines on perioperative venous thromboembolism prophylaxis: Surgery 
      in the elderly.
PG  - 116-122
LID - 10.1097/EJA.0000000000000705 [doi]
AB  - : The risk for postoperative venous thromboembolism (VTE) is increased in 
      patients aged more than 70 years and in elderly patients presenting with 
      co-morbidities, for example cardiovascular disorders, malignancy or renal 
      insufficiency. Therefore, risk stratification, correction of modifiable risks and 
      sustained perioperative thromboprophylaxis are essential in this patient 
      population. Timing and dosing of pharmacoprophylaxis may be adopted from the 
      non-aged population. Direct oral anti-coagulants are effective and well tolerated 
      in the elderly; statins may not replace pharmacological thromboprophylaxis. Early 
      mobilisation and use of non-pharmacological means of thromboprophylaxis should be 
      exploited. In elderly patients, we suggest identification of co-morbidities 
      increasing the risk for VTE (e.g. congestive heart failure, pulmonary circulation 
      disorder, renal failure, lymphoma, metastatic cancer, obesity, arthritis, 
      post-menopausal oestrogen therapy) and correction if present (e.g. anaemia, 
      coagulopathy) (Grade 2C). We suggest against bilateral knee replacement in 
      elderly and frail patients (Grade 2C). We suggest timing and dosing of 
      pharmacological VTE prophylaxis as in the non-aged population (Grade 2C). In 
      elderly patients with renal failure, low-dose unfractionated heparin (UFH) may be 
      used or weight-adjusted dosing of low molecular weight heparin (Grade 2C). In the 
      elderly, we recommend careful prescription of postoperative VTE prophylaxis and 
      early postoperative mobilisation (Grade 1C). We recommend multi-faceted 
      interventions for VTE prophylaxis in elderly and frail patients, including 
      pneumatic compression devices, low molecular weight heparin (and/or direct oral 
      anti-coagulants after knee or hip replacement) (Grade 1C). : This article is part 
      of the European guidelines on perioperative venous thromboembolism prophylaxis. 
      For details concerning background, methods, and members of the ESA VTE Guidelines 
      Task Force, please, refer to:Samama CM, Afshari A, for the ESA VTE Guidelines 
      Task Force. European guidelines on perioperative venous thromboembolism 
      prophylaxis. Eur J Anaesthesiol 2018; 35:73-76.A synopsis of all recommendations 
      can be found in the following accompanying article: Afshari A, Ageno W, Ahmed A, 
      et al., for the ESA VTE Guidelines Task Force. European Guidelines on 
      perioperative venous thromboembolism prophylaxis. Executive summary. Eur J 
      Anaesthesiol 2018; 35:77-83.
FAU - Kozek-Langenecker, Sibylle
AU  - Kozek-Langenecker S
AD  - From the Sigmund Freud Private University and Department of Anaesthesia and 
      Intensive Care, Evangelical Hospital Vienna, Vienna, Austria (SK-L), Department 
      of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark (CF-E), 
      Orthopaedic Surgery, University Hospital Saint Luc, Brussels, Belgium (ET), and 
      Department of Surgery, Lithuanian University of Health Sciences, Kaunas, 
      Lithuania (GB).
FAU - Fenger-Eriksen, Christian
AU  - Fenger-Eriksen C
FAU - Thienpont, Emmanuel
AU  - Thienpont E
FAU - Barauskas, Giedrius
AU  - Barauskas G
CN  - ESA VTE Guidelines Task Force
LA  - eng
PT  - Journal Article
PT  - Practice Guideline
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Anaesthesiol
JT  - European journal of anaesthesiology
JID - 8411711
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Administration, Oral
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Anesthesiology/instrumentation/methods/standards
MH  - Anticoagulants/administration & dosage/adverse effects/standards
MH  - Critical Care/methods/standards
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Early Ambulation/adverse effects/standards
MH  - Europe
MH  - Female
MH  - Frail Elderly
MH  - Geriatric Assessment/methods
MH  - Heparin, Low-Molecular-Weight/administration & dosage/adverse effects
MH  - Humans
MH  - Intermittent Pneumatic Compression Devices
MH  - Male
MH  - Perioperative Care/instrumentation/methods/*standards
MH  - Postoperative Complications/etiology/*prevention & control
MH  - Pulmonary Embolism/etiology/*prevention & control
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - Societies, Medical/standards
MH  - Stockings, Compression/adverse effects
MH  - Surgical Procedures, Operative/*adverse effects
MH  - Venous Thromboembolism/etiology/*prevention & control
EDAT- 2017/09/14 06:00
MHDA- 2019/09/24 06:00
CRDT- 2017/09/14 06:00
PHST- 2017/09/14 06:00 [pubmed]
PHST- 2019/09/24 06:00 [medline]
PHST- 2017/09/14 06:00 [entrez]
AID - 10.1097/EJA.0000000000000705 [doi]
PST - ppublish
SO  - Eur J Anaesthesiol. 2018 Feb;35(2):116-122. doi: 10.1097/EJA.0000000000000705.