Venous thromboembolic disease in the older surgical patient part I: Prophylaxis

Older adults undergoing major surgical procedures are at high risk for developing deep vein thrombosis (DVT) and pulmonary embolism (PE). This two-part article reviews the prophylaxis, diagnosis, and management of DVT and PE in older surgical patients. Over the past 30 years, numerous studies have documented the efficacy of various prophylactic regimens for reducing the risk of DVT and PE, including low-dose unfractionated heparin, low-molecular-weight heparin (LMWH), warfarin, intermittent pneumatic compression, and more recently, fondaparinux. Optimal use of these measures has been shown to reduce the risk of peri-operative VTED by 50-90%.