Mechanical Prophylaxis Management of Venous Thromboembolism in a General Surgical Setting: A Retrospective Cohort...

Patients undergoing pancreatectomy and hepatectomy are at high risk of venous thromboembolism (VTE) and bleeding. Mechanical prophylaxis effectively prevents VTE, yet optimal management strategies remain debated. This study compared two mechanical prophylaxis regimens in these surgical populations.

This retrospective study (January 2017-December 2022) included patients managed under distinct protocols: those admitted during 2017-2018 received the Assessment-Prophylaxis (AP) regimen (n = 176), while those admitted during 2019-2022 received the Assessment-Screening-Prophylaxis-Evaluation (ASPE) regimen (n = 627). Univariate analysis (chi-square test) and multivariate logistic regression were performed to assess hospital-associated VTE (HA-VTE) outcomes.

The ASPE group demonstrated higher VTE risk assessment rates at admission (94.4% vs. 46.0%, p < 0.001), ultrasound screening rates (45.3% vs. 1.2%, p < 0.001), and postoperative mechanical prophylaxis rates (98.4% vs. 92.8%, p = 0.001). However, HA-VTE incidence did not differ significantly between groups (1.9% vs. 1.1%, p = 0.486). Multivariate analysis identified prolonged hospitalization (OR = 1.057, 95% CI: 1.024-1.090, p = 0.001) and admission VTE risk assessment (OR = 9.347, 95% CI: 1.089-80.214, p = 0.042) as independent risk factors for HA-VTE, while postoperative mechanical prophylaxis reduced HA-VTE risk (OR = 0.081, 95% CI: 0.016-0.408, p = 0.002).

The ASPE regimen improved compliance with VTE prevention protocols. Postoperative mechanical prophylaxis significantly reduced HA-VTE incidence, supporting its clinical adoption.