Venous thromboembolism (VTE) is a major cause of perioperative morbidity and mortality. Each year 25 000 people in England die from VTE. Without prophylaxis, 40-80 % of high risk patients develop detectable DVTs and up to 10 % die of PE.

Risk factors for VTE include:

Patient factors

Associated diseases

Operation factors

Venous thromboembolism (VTE) is a major cause of perioperative morbidity and mortality. Each year 25 000 people in England die from VTE. Without prophylaxis, 40-80 % of high risk patients develop detectable DVTs and up to 10 % die of PE.

Risk factors for VTE include:

Patient factors

• Age >60 years
• Previous DVT, PE, thrombophilia e.g. protein C, S deficiency, Factor V Leiden
• Pregnancy
• Puerperium
• Oestrogen therapy (HRT, oral contraceptive pill (OCP))
• Obesity (BMI >30 kg/m²)
• Immobility
• Continuous travel of >3 h approximately 4 weeks before/after surgery

Associated diseases

Operation factors

Venous thromboembolism (VTE) is a major cause of perioperative morbidity and mortality. Each year 25 000 people in England die from VTE. Without prophylaxis, 40-80 % of high risk patients develop detectable DVTs and up to 10 % die of PE.

Risk factors for VTE include:

Patient factors

Associated diseases

• Active heart or respiratory failure
• Acute medical illness/infection
• Recent cerebrovascular event (CVE)/myocardial infarction (MI)
• Varicose veins with phlebitis
• Trauma (especially lower limb fractures or spinal injury)
• Haematological diseases, e.g. paraproteinaemia
• Nephrotic syndrome
• Inflammatory bowel disease (Crohn’s or UC)

Operation factors

Venous thromboembolism (VTE) is a major cause of perioperative morbidity and mortality. Each year 25 000 people in England die from VTE. Without prophylaxis, 40-80 % of high risk patients develop detectable DVTs and up to 10 % die of PE.

Risk factors for VTE include:

Patient factors

Associated diseases

Operation factors

• Surgery lasting <30 min is considered minor (low risk)
• Surgery lasting >30 min is considered major (higher risk)
• Types of surgery considered high risk include major joint replacements, hip fracture surgery and surgery to the abdomen and pelvis

NB: Any patient confined to bed is at risk of VTE.