“It’s Good To Talk” - An Audit of the Communication of Post-Operative Thromboembolic Complications

AbstractThe risk of venous thromboembolism after surgery, with its associated morbidity and mortality, is an important component of obtaining informed consent for a surgical procedure. This risk of thromboembolic complications extends beyond the post-operative hospital stay; patients suffering such complications after discharge are generally not re-admitted under the care of the operating surgeon. A retrospective opening loop audit was undertaken to investigate the communication of post-operative thromboembolic complications between specialties in a large district general hospital. The operating surgeon was unaware of 87% of cases of pulmonary embolism and 20% of cases of deep vein thrombosis affecting patients in their post-operative period. The interspecialty communication of post-operative complications is important to maintain a high standard of patient care and allow surgeons to make informed decisions about clinical practice.

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The Risk and Efficacy of Anticoagulant Therapy in the Treatment of Thromboembolic Complications in Patients with Primary Malignant Brain Tumors

Neurosurgery ◽

10.1227/00006123-199007000-00010 ◽

1990 ◽

Vol 27 (1) ◽

pp. 74-77 ◽

Cited By ~ 60

Author(s):

Eric Altschuler ◽

Hans Moosa ◽

Robert G. Selker ◽

Frank T. Vertosick

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Anticoagulant Therapy ◽

Warfarin Therapy ◽

Oral Anticoagulant Therapy ◽

Effective Means ◽

Thromboembolic Complications ◽

Intratumoral Hemorrhage ◽

Vein Thrombosis ◽

Deep Vein

Abstract Twenty-three patients with malignant glial neoplasms were treated with anticoagulant therapy for thromboembolic complications. Fifteen patients had deep vein thrombosis alone, and 8 patients had both deep vein thrombosis and pulmonary embolism. Serum prothrombin times were maintained at 1.25 times control for an average of 5.8 months per patient, for a total patient exposure to warfarin therapy of 132 patient-months (11 patient-years). Only 1 patient suffered a recurrent pulmonary embolism, and this occurred during an episode of gastrointestinal bleeding, when anticoagulant therapy had to be discontinued prematurely. All patients were followed with serial computed tomographic or magnetic resonance imaging scans, and no patient showed radiographic evidence of intratumoral hemorrhage either during or after warfarin therapy. One patient, who died from a large recurrent glioblastoma, was found at autopsy to have scattered foci of intratumoral hemorrhage. This series, together with a review of the available literature, suggests that oral anticoagulant therapy is both a safe and effective means of treating thromboembolic complications in patients with residual malignant glial tumors.

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Prevention of Thromboembolic Complications in Patients with Postphlebitic Lower Extremities Syndrome

Journal of restorative medicine and rehabilitation ◽

10.38025/2078-1962-2021-20-5-19-25 ◽

2021 ◽

Vol 20 (5) ◽

pp. 19-25

Author(s):

Tatyana A. Knyazeva ◽

Mikhail V. Nikitin ◽

Tatayna I. Nikiforova

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Clinical Medicine ◽

Lower Extremities ◽

Medical Rehabilitation ◽

Minimal Risk ◽

Thromboembolic Complications ◽

Vein Thrombosis ◽

Mechanical Methods ◽

Deep Vein

Prevention of venous thromboembolic complications (pulmonary embolism, stroke, deep vein thrombosis) remains the most important clinical medicine problem and affects all doctors’ professional expertise areas without exeption due to an extremely high potential risk to the health and life of patients that might cause thromboembolic complications. A worldwide trend is to use conservative methods of treatment and prevention of pulmonary embolism, stroke, deep vein thrombosis, which are most often limited to the use of compression treatment, periodic appointment of phlebotropic medications courses. At the same time, effective and safe methods of using non-drug technologies for the prevention of thromboembolic complications in patients, in particular, with postphlebitic lower extremities syndrome, are in progress. They can prevent and/or significantly reduce the number of life-threatening complications and mortality with minimal risk of bleeding. The article presents a review of the literature data using the Russian and foreign sources on the use of medicinal and non-medicinal,mechanical methods of medical rehabilitation and sanatorium-resort treatment of patients with preventive effect on the dangerous thromboembolic complications occurrence.

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Venous Thromboembolism after Brain Tumor Surgery: A Retrospective Review

Neurosurgery ◽

10.1227/00006123-199106000-00012 ◽

1991 ◽

Vol 28 (6) ◽

pp. 859-863 ◽

Cited By ~ 37

Author(s):

Allan D. O. Levi ◽

Christopher M. Wallace ◽

Mark Bernstein ◽

Beverly C. Walters

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Incidence Rate ◽

Incidence Rates ◽

Thromboembolic Complications ◽

Brain Tumor Surgery ◽

Surgical Time ◽

Vein Thrombosis ◽

Increased Risk ◽

Deep Vein

Abstract We retrospectively reviewed the incidence rate of clinical postoperative deep vein thrombosis and/or pulmonary embolism in 1703 patients undergoing initial craniotomy for meningioma, glioma, or cerebral metastasis. The incidence rate of clinical thromboembolic complications was 1.59% for all tumor groups within the first 4 weeks of surgery. Patients undergoing surgery for meningiomas had a statistically significant increased risk of thromboembolism despite fewer overall perioperative risk factors, when compared with the other tumor groups. The tumor-specific incidence rates of deep vein thrombosis and/or pulmonary embolism for meningioma, glioma, and metastasis were 3.09%, 0.97%, and 1.03%, respectively. Whether this difference was a result of increased surgical time or an inherent property of meningiomas could not be ascertained.

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Complications of deep vein thrombosis: pulmonary thromboembolism and venous gangrene of the lower extremities (clinical case)

Wounds and wound infections The prof B M Kostyuchenok journal ◽

10.25199/2408-9613-2019-6-2-44-59 ◽

2019 ◽

Vol 6 (2) ◽

pp. 44-59

Author(s):

S. A. Orudzheva ◽

V. A. Mitish ◽

S. D. Magomedova ◽

A. A. Ushakov ◽

L. A. Blatun ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Venous Thrombosis ◽

Lower Extremities ◽

Late Diagnosis ◽

Thromboembolic Complications ◽

Vein Thrombosis ◽

Risk Of Death ◽

Venous Gangrene ◽

Deep Vein

Venous thrombosis and thromboembolic complications are an important public health problem. According to current recommendations for the diagnosis, treatment and prevention of venous thromboembolic complications, patients are stratified by the risk of pulmonary embolism, by the risk of death in pulmonary embolism, respectively, diagnostic and therapeutic tactics are recommended. Adherence to the recommendations allows to reduce mortality from pulmonary embolism, in the opposite case, mortality from pulmonary embolism remains high due to the problems of rapid diagnosis and risk-adjusted therapy. If pulmonary embolism is a frequent complication of venous thrombosis, then venous gangrene is a rather rare complication, which is also characterized by high mortality. A rare case of a combination of two serious complications of deep vein thrombosis is described: thromboembolism of the pulmonary artery and venous gangrene of both lower extremities. Late diagnosis and late treatment led to amputation of both lower extremities, performed in the presence of a floating thrombus in the inferior vena cava and right heart. The causes of late diagnosis and the complexity of the treatment of simultaneously developed two complications are analyzed.

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