Perioperative medicine & outcomes
Extended pharmacological thromboprophylaxis and clinically relevant venous thromboembolism after major abdominal and pelvic surgery: international, prospective, propensity score-weighted cohort study
Authors' conclusion
In modern practice, the incidence of postoperative venous thromboembolism is low. Extended prophylaxis appears safe, yet the clinical efficacy remains uncertain.
Study context
- Population
- Consecutive adults undergoing major abdominopelvic surgery, 29 countries (January-May 2022)
- Participants
- 11,571 adults · 29 countries
- Exposure
- Extended pharmacological thromboprophylaxis vs no extended prophylaxis
- Extended prophylaxisn = 3,670
- Outcome
- Clinically relevant VTE (primary efficacy outcome; European Medicines Agency definitions)
- Follow-up
- 30 days after surgery
Methodological detailsinternational, propensity score-weighted, mixed-effects logistic regression, Extended prophylaxis prescription rate 31.7% (3670 patients)
- International
- Propensity score-weighted
- Mixed-effects logistic regression
- Extended prophylaxis prescription rate 31.7% (3670 patients)
Main finding
As reported in the abstract
Clinically relevant VTE (overall cohort)
- Extended prophylaxis not significantly associated with decreased VTE incidence
- Propensity score weighted
Observational data: associations, not effects.
Further findings
Clinically relevant VTE (subgroup: complex major surgery and active cancer) · 30 days after surgery
- Extended prophylaxis not significantly associated with decreased VTE incidence in this subgroup
- Subgroup analysis
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Clinically relevant bleeding (primary safety outcome) · 30 days after surgeryAfter weighting · propensity score-weighted | 1.07 (0.64–1.81) | P = 0.792 | |
| 0.512Odds ratio (log scale) |
- Clinically relevant bleeding (primary safety outcome) — Post-discharge bleeding rate, overall cohort
- 0.7% (85 patients)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Extended pharmacological thromboprophylaxis and clinically relevant venous thromboembolism after major abdominal and pelvic surgery: international, prospective, propensity score-weighted cohort study. Br J Surg. Published 11 March 2025. doi:10.
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