It is usual to stop prophylaxis of most surgical patients at hospital discharge. However, there is increas ing evidence that some patients are at risk of thromboem bolism after treatment is stopped. Some evidence and several proposals from the literature are presented, but to date, the situation remains unclear.
Hull RDPrevention of venous thromboembolism: key questions that need to be answered . In: Bergqvist D, Comerota AJ, Nicolaides AN , Scurr JH, eds. Prevention of venous thromboembolism . London: Med Orion, 1994:421.
2.
Arcellus JI, Caprini JA, Traverso CIVenous thromboembolism after hospital discharge. Semin Thromb Hemost1993;19(1):142.
3.
Bergqvist D.Long term prophylaxis following orthopedic surgery . Haemostasis1993;23(Suppl 1):27.
4.
Wille-Jorgensen P., Lausen I., Jorgensen LNIs there a need for long term thromboprophylaxis following general surgery ?Haemostasis1993 ;23(Suppl 1):10.
Sevitt S.Venous thrombosis and pulmonary embolism: their prevention by oral anticoagulants . Am J Surg1962;33:703.
7.
Bergqvist D. , Lindblad B.Embolism verified at autopsy: an analysis of 1274 surgical patients. Br J Surg1985;72:105.
8.
Huber O., Bounameaux H., Borst F., Rohner A.L'cmbolic pulmonaire après la sortie de l'hopital: un risque sousestimé . Med Hyg1992;50:106.
9.
Flinn WR, Sandager GP, Cerullo LJDuplex venous scanning for the prospective surveillance of perioperative venous thrombosis. Arch Surg1989;124:901.
10.
Fricker JP, Vergnes Y., Kher A., Cazeanave JPLow dose heparin versus LMWH (Kabi) in the prophylaxis of thromboembolic complications of abdominal oncology surgery. Eur J Clin Invest1988;18:561.
11.
Johnson R., Green JR, Charnley J.Pulmonary embolism and its prophylaxis following the Charnley total hip replacement . Clin Orthop1977;127:123.
12.
Bergqvist D. , Elvelin R., Erikson U., Hjelmstedt A.Thrombosis following hip arthroplasty—a study using phlebography and 125I fibrinogen test. Acta Orthop Scand1976;47: 549.
13.
Torngren S.Pulmonary embolism and post operative death . Acta Chir Scand1983;149:269.
14.
Raimbeau G. , Galland F., Pidhorz L.Les complications thromboemboliques après orthroplastics couplées de hanche. Ann Chir1983;37:291.
15.
Paiement GD , Wessinger SJ, Harris WHSurvey of prophylaxis against venous thromboembolism in adults undergoing hip surgery. Clin Orthop1987;223:188.
16.
Sorensen C. , Andersen M., Kristiansen V., Jensen R., Wille Jorgensen P.Development of late thromboembolic complications after major elective abdominal surgery—an interim report . Thromb Haemost1989;62:129.
17.
Wolf LD, Hozack WJ, Rothman RHPulmonary embolism in total joint arthroplasty. Clin Orthop1993;228:219.
18.
Pellegrini VD, Langhans MJ, Totterman S., et al. Embolic complications of calf thrombosis following total hip arthroplasty. J Arthroplasty1993;8(5):449.
19.
Lotke PA, Steinberg ME, Ecker MISignificance of deep venous thrombosis in the lower extremity after total joint arthroplasty. Clin Orthop1994 ;229:25.
20.
Schauble JF , Anlyan WG, Deaton HL, et al. A study of recurrent pulmonary embolism . Arch Surg1960;80:105.
21.
Scurr JH, Coleridge-Smith PD, Hasty JHDeep venous thrombosis: a continuing problem. Br Med J1988;297:28.
22.
Hampson Wgj , Harris PC, Lucas HK, et al. Failure of low dose heparin to prevent deep vein thrombosis after hip replacement arthroplasty . Lancet1974;2:795.
23.
Manucci PM, Citterio LE, Panajotopoulos N.Low dose heparin and deep vein thrombosis after total hip replacement . Thromb Haemost1976;36:157.
24.
Sikorski JM , Hampson WG, Staddon GEThe natural history and aetiology of deep vein thrombosis after total hip replacement. J Bone Joint Surg1981;63B(2):171.
25.
Seagroatt V. , Tansoon M., Glodacre M., et al. Elective total hip replacement: incidence, emergency readmission rate and post operative mortality. Br Med J1991;303:1431.
26.
Kakkar VV, Cohen AT, Edmonson RA, et al. Low molecular weight versus standard heparin for prevention of venous thromboembolism after major abdominal surgery. Lancet1993;341:259.
27.
Clarke-Pearson DL, Synan IS, Coleman REThe natural history of postoperative venous thromboembolic in gynecologic oncology—a prospective study of 382 patients . Am J Obstet Gynecol1984;148:1051.
28.
Agnelli G., Ranucci V., Cosmi B., et al. Outcome of hip surgery patients with lower limb negative venography at discharge. Thromb Haemost1991;65(5):abstr 1727.
29.
Round table discussion on thromboembolism in surgery. Semin Thromb Hemost1991;17(Suppl 3):329.
30.
Woolson ST, McRory D., Walter JF, et al. B-mode ultrasound scanning in the detection of proximal venous thrombosis after total hip replacement. J Bone Joint Surg1990; 72A:983.
31.
Toulemonde F., Kher A., Doutremepuich C., Difficultés d' appréciation des embolics pulmonaires post opératoires. Risques d'une méta-analyse des essais cliniques . Presse Méd1993;22:28.
32.
Lassen MR, Borris LC, Christiansen HM, et al. Clinical trials with LMWH in the prevention of post operative thromboembolic complications: a meta-analysis. Semin Thromb Hemost1991;17(Suppl 3):284.
33.
Planes A., Silsiguen M., Vochelle N.Prophylaxis in elective hip surgery. In: Bergqvist D, Comerota AJ, Nicolaides AN, Scurr JH, eds. Prevention of venous thromboembolism. London : Med Orion, 1994:271.
34.
Trowbridge A., Boese CK, Woodruff B., et al. Incidence of post hospitalization proximal deep venous thrombosis after total hip arthroplasty. A pilot study . Clin Orthop1994;299: 203.
35.
Francis CW, Pellegrini VD, Stulberg RN, et al. Prevention of venous thrombosis after total knee arthroplasty . J Bone Joint Surg1990;72A(7):976.
36.
Perot GJ, Picard B., Viennois M.Essai de prophylaxie de la maladie thromboembolique post opératoire par des faibles doses d'héparinate de calcium. La maladie thromboembolique post opératoire—Antenne médicale ( Nice) 1973;6:131.
37.
Fogliani J., Sampol J., Tournigand T.Modifications des tests explorant l'hémostase au cours de la période post opératoire. Marseille Med1973;1:7.
38.
Jausseran JM , Baille Y., Monties JR, et al. Le diagnostic biologique de la tendance thrombogène post opératoire . Marseille Med1970;9:637.
39.
Schondorf TH , Paplham H., Franz K.Determination of heparin, PTT and antithrombin III after subcutaneous heparin administration. In: Witt I, ed. Heparin-new biochemical and medical aspects . Berlin: de Gruyter, 1982:315.
40.
Leyvraz PF, Richard J., Bachmann F., et al. Adjusted versus fixed dose subcutaneous heparin in the prevention of deep vein thrombosis after total hip replacement. N Engl J Med1983;309:954.
41.
Samama M., Conard J., Horellou MH, Toulemonde F.Coagulation abnormalities predisposing to the development of deep vein thrombosis . In: Bergqvist D, Comerota AJ, Nicolaides AN, Scurr JH, eds. Prevention of venous thromboembolism . London: Med Orion, 1994:45.
42.
Comerota AJOperative venous dilatation and its relationship to post operative deep vein thrombosis. In: Bergqvist D, Comerota AJ, Nicolaïdes AN , Scurr JH, eds. Prevention of venous thromboembolism. London: Med Orion, 1994:31.
43.
Browse NLEffect of bedrest on resting calf blood flow. Br Med J1962;1:1714.
44.
Mc Nally MA , Mollan Rab.Total hip replacement, lower limb blood flow and venous thrombogenesis. J Bone Joint Surg1993;75B:640.
45.
Bird AD, The effect of surgery, injury and prolonged bedrest on calf blood flow. Aust NZ J Surg1972;41:374.
46.
Planes A., Vochelle N., Fagola M.Total hip replacement and deep vein thrombosis. A venographic and necropsy study. J Bone Joint Surg1990;72B:9.
47.
Bergqvist D. , Burmak US, Frisell J., et al. Low molecular weight heparin once daily compared with conventional low dose heparin twice daily. Br J Surg1986;73(3):204.
48.
Sagar S., Stamatakis JD, Kakkar VV, et al. Efficacy of low dose heparin in prevention of extensive deep vein thrombosis in patients undergoing total hip replacement. Lancet1976;1:1151.
49.
Eriksson BI , Kalebo P., Anthymir BO, et al. Prevention of deep vein thrombosis and pulmonary embolism after total hip replacement. J Bone Joint Surg1991;73A(4):484.
50.
Crandon AJ, Peel KR, Anderson JA, Thompson V., McNicol GP. Post operative deep vein thrombosis: identifying high risk patients . Br Med J1980;281:343.
51.
Bergqvist D.Prophylaxis against post operative venous thromboembolism. A survey of surveys. Thromb Haemost Dis1990 ;22:69.
52.
European ConsensusStatement (Windsor). Prevention of venous thromboembolism . Int Angiol1991:151.
53.
Laverick MD , Croal SA, Mollan Rab.Orthopedic surgeons and thromboprophylaxis . Br Med J1991;303:549.
54.
Anderson FA , Wheeler HB, Goldberg RJ, et al. Prospective study of the impact of continuing medical education and quality assurance programs on use of prophylaxis for venous thromboembolism. Arch Intern Med1994;154:669.
55.
Cooke EDThe current practice of prevention. In: Bergqvist D, Comerota AJ, Nicolaides AN, Scurr JH, eds. Prevention of venous thromboembolism. London : Med Orion, 1994:123.
56.
Consensus Conference (Paris).Prophylaxie des thromboses veineuses profondes et des embolies pulmonaires post opératoires. Ann Fr Anesth Reanim1992 ;11:243.
57.
Wheeler HB, Anderson FA Jr.Diagnostic methods for deep vein thrombosis. Haemostasis1995;25:6.
58.
Wicky J., Bongard O., Peter R., Bounameaux H.Screening for proximal DVT using B-mode venous ultrasonography following major hip surgery: implications for clinical management. Vasa1994;23:330.
59.
Haas S., Tribus CB, Insall JN, et al. The significance of calf vein after total knee arthroplasty . J Bone Joint Surg1992;74B(6):799.
60.
Saeger W., Genzkow M.Venous thromboses and pulmonary embolisms in post mortem series: probable causes by correlations of clinical data and basic diseases. Path Res Pract1994;190:394.
61.
Picolet H., Leizorovicz A., Revel D., et al. Reliability of phlebography in the assessment of venous thrombosis in clinical trial. Haemostasis1990;20:362.
62.
Lensing Awa, Büller HR, Hirsh J., Ten Cate JWDiagnostic of deep vein thrombosis in asymptomatic patients. In: Bergqvist D, Comerota AJ , Nicolaides AN, Scurr JH, eds. Prevention of venous thromboembolism. London: Med Orion , 1994:73.
63.
Borris LC, Lassen MRVenography in asymptomatic patients having total hip replacement. Interobserver variation. In: Bergqvist D, Comerota AJ, Nicolaides AN , Scurr JH, eds. Prevention of venous thromboembohsm. London: Med Orion, 1994:103.
64.
Minar E., Ehringer H., Sommer G., et al. Prevention of post venographic thrombosis by heparin flush. AJR1984;143:629.
65.
Thromboembolic Risk Factors (THRIFT) Consensus Group. Risk of prophylaxis for venous thromboembolism in hospital patients. Br Med J1992;305:567.
66.
Green D., Hull R., Mammon E., et al. Deep vein thrombosis in spinal cord injury. Chest1992;102:633S.
67.
Hulsman MV, Nurmohamed M., Ten Cate JWMechanical prophylaxis of deep vein thrombosis. Semin Thromb Hemost1991;17(Suppl 3):269.
68.
Merle d'Aubigné R., Tubiana R., Duparc J.Les complications thromboemboliques en chirurgie orthopédique. Leur fréquence et leur prévention. Mém Acad Chir1955;81:1011.
69.
Clagett P.Prevention of post operative venous thromboembolism. An update. Am J Surg1994;168:515.