[Evaluation of our manual for prevention of perioperative pulmonary embolism]

All patients scheduled for surgical procedures were divided into three groups depending on risk grade for pulmonary embolism (PE) in our hospital from August, 2001. Based on our experience of two PE cases after gynecologic surgery, we introduced the perioperative manual for prevention of PE from April, 2003. According to the manual criteria, we could decide indications for the physical prophylaxis or anticoagulant preventive treatment for the patients. In spite of introduction of the manual, two cases of PE occurred after femoral head prosthetic replacement for femoral head fracture patients classified low risk group in our criteria. The Japanese guideline for prevention of venous thromboembolism was published in January, 2004, but even low risk group patients were candidates for PE depending on the surgery and the situation. Even after installation of the guideline for PE, careful perioperative examination is mandatory to prevent and treat PE.