Venous Thromboembolism Prophylaxis in Surgical Patients

Scott Kaatz, DO, MSc, FACP, SFHM

Based on the orginal Venous Thromboembolism Prophylaxis in Surgical Patients, by Charles Locke, MD, Michael Steiff, MD and Leonard Feldman, MD.  

Summary

Venous thromboembolism (VTE) prophylaxis in the surgical patient remains an important medical issue. Research has shown that VTE, which includes deep vein thrombosis and pulmonary embolism, occurs frequently in hospitalized patients who have undergone general, major gynecologic, major urologic, major orthopedic, or neurosurgery if preventive measures are not taken. Although it is impossible to predict with certainty which surgical patients will develop VTE, it is important for medical consultants to have a working knowledge of the different risk factors for VTE as well as current prophylaxis recommendations in order to employ appropriate strategies to reduce the risk of VTE. The following module discusses the clinical impact of VTE in surgical patients, reviews the various risk factors for VTE in surgical patients, and discusses prophylaxis options. In addition, goals for VTE prophylaxis and methods for evaluating when and how to initiate prophylaxis and determining the length of pharmacologic intervention are provided using recent research and the American College of Chest Physicians 2012 guidelines.

Goal

To provide hospitalists with current data and guidelines regarding venous thromboembolism prophylaxis in surgical patients.

Target Audience

This activity is designed for hospitalists. No prerequisites required.

Learning Objectives

After completing the module, the participant should be able to:

  1. Recognize the clinical impact of venous thromboembolism (VTE) on surgical patients.
  2. Describe the risk factors that increase the likelihood of developing a VTE and how to risk stratify surgical patients based on these factors.
  3. Formulate the goals of prophylactic intervention programs.
  4. Summarize the VTE prophylaxis regimens for general and abdominopelvic surgery patients.
  5. Summarize the VTE pharmacoprophylaxis regimens for major orthopedic surgery patients.
  6. Outline when to initiate VTE chemoprophylaxis and the current roles of extended VTE chemoprophylaxis.
Acrreditation Statement 

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2.0 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date & expiration date: 11/12/2018- 11/12/2021 
Estimated time to complete: 2 hours

Conflict of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Instructions

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.

Additional Information

Course summary
Available credit: 
  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
Course opens: 
11/12/2018
Course expires: 
11/12/2021
Your cost:
$0.00
Parent activity set: 
Rating: 
0
Faculty & Disclosure
Author

Scott Kaatz, DO, MSc, FACP, SFHM
Clinical Associate Professor of Medicine - Wayne State University
Senior Staff Hospitalist
Medical Director for Professional Development and Research
Division of Hospital Medicine
Henry Ford Hospital
Detroit, Michigan 

Dr. Kaatz reports sitting on the advisory board/committee for Janssen, Bristol Myer Squibb, Pfizer, Portola and Roche, has recevied research grants or contracts from Janssen, and consults for Pfizer. 

Editors:

Leonard Feldman, MD, FACP, SFHM
Associate Professor of Medicine 
Johns Hopkins University School of Medicine 
Urban Health Residency and Track Director
Associate Program Director, Osler Medical Residency
Director, Comprehensive General Medicine Consult Service
Founding Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Baltimore, Maryland

Dr. Feldman reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Kurt Pfeifer, MD, FACP, SFHM
Professor of Medicine
General Internal Medicine
Medical Director, Froedtert and Medical College of Wisconsin Eye Institute Perioperative Services
Medical College of Wisconsin
Associate Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Milwaukee, Wisconsin

Dr. Pfeifer reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

SHM Conflict Of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Available Credit

  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit

Accreditation Period

Course opens: 
11/12/2018
Course expires: 
11/12/2021

Price

Your cost:
$0.00
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The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.

Click START to begin.