Antithrombosis routines and hemorrhagic complications: a seven year survey comparing vascular and general surgical operations

Prospective monitoring of the occurrence of venous thromboembolism (VTE) and bleeding complications was carried out during a seven year period in a department of general and vascular surgery. Low dose heparin was given by pre-determined criteria to over 1200 patients undergoing general surgical operations, and to almost 700 patients having vascular surgical operations. Over 450 vascular patients received full dose anticoagulation and 3400 patients from both groups received no antithrombotic treatment. Clinically significant major VTE occurred in one percent of all patients. Nine patients died of pulmonary emboli (0.15%). There were 130 patients with bleeding complications (2.2%) half of them severe. Both VTE and bleeding were more common in the vascular patients (1.4 and 3.1% respectively) as compared with general surgery (0.7 and 1.6%). Patients receiving low dose heparin had a 3.4 percent incidence of bleeding but in one half of these cases a technical factor or a breach of the treatment protocol could have contributed to the bleeding. Possible modifications of antithrombosis routines are suggested.