NOTE: This module is currently in the process of being updated and recertified, and so does not currently offer CME. A fully updated module eligible for CME is expected to be available May 2024.

Scott Kaatz, DO, MSc, FACP, SFHM

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

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

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 mitigates 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.