Thromboprophylaxis in lower limb amputation surgery

Lower limb amputation surgery is associated with a high risk of venous thromboembolism. There is evidence that pharmacological thromboprophylaxis is not widely prescribed to patients undergoing this type of procedure.

To investigate the profile of the thromboprophylaxis practices of angiologists and vascular surgeons in Brazil during the perioperative period of lower limb amputation surgery and conduct a descriptive analysis of the findings.

This is a cross-sectional, descriptive study, with simple probabilistic sampling, carried out with angiologists and vascular surgeons working in Brazil. Data were collected through electronic questionnaires, from February to June 2023.

There were 237 respondents, 58.6% of whom conduct thrombotic risk stratification. Of these, 86.3% use the Caprini score. Only 27% of participants stratify patients' bleeding risk. Low molecular weight heparin is the medication of choice for 85.7% of study participants, 78.9% of whom use a dosage of 40 IU per day. Around 46.8% use direct oral anticoagulants in addition to low molecular weight heparin and rivaroxaban is the drug they most often prescribe (94.6%). A little more than half (51.15%) routinely recommend pharmacological thromboprophylaxis until hospital discharge.

The study revealed the heterogeneous nature of conduct related to prescription of pharmacological thromboprophylaxis, highlighting the need for more studies to support prophylaxis decision-making in this patient population.