Low molecular weight heparin in prophylaxis of deep vein thrombosis in Asian general surgical patients: A Kashmir experience

Abstract

Background and Objectives:Deep vein thrombosis (DVT) occurs at a lower rate in Asia than in the rest of the world. We wanted to study the significance and efficacy of low molecular weight heparin (LMWH) in prophylaxis of DVT in major general surgical patients in the Kashmir Valley (India, Asia) so as to make it a routine in our patients.Patients and Methods:This was a prospective study in which the effect of LMWH was compared with no prophylaxis.Results:LMWHs are more effective than no prophylaxis in the prevention of DVT and pulmonary thromboembolism in highest-risk general surgical patients (odds ratio = 16.64; 95% confidence interval = 3.63–1130.03; P-value = 0.014).Conclusion:LMWHs have a significant prophylactic effect on DVT in general surgical patients, with a higher benefit to risk ratio, and, in spite of the low incidence of DVT in Asia, its prophylaxis should routinely be considered in this part of the world as well, preferably in the form of LMWHs.

Incidence of Venous Thromboembolism and Its Pharmacological Prophylaxis in Asian General Surgery Patients: A Systematic Review

“…One study [17] included patients who underwent abdominal surgery, four studies [7, 8, 12, 14] included only gastric cancer patients, while seven studies [10, 11, 13, 15, 16, 19, 20] examined patients with colorectal cancer. The other two studies [9, 18] looked at patients after general surgery procedures, the majority of which were abdominal operations.…”

“…The actual number of patients diagnosed with symptomatic DVT was 14 of 560 (2.5 %). Note that Dar et al [9] routinely performed venous duplex scans to detect DVT, which probably explains the higher rate of DVT compared to that of the other studies. In comparison, Ho et al [20] used routine clinical assessment supplemented by a hand‐held Doppler probe to detect venous flow on muscle squeezing as an indication for venous duplex scanning.…”

Different doses of enoxaparin in the prevention of postoperative abdominal adhesions. Experimental study

“…In abdominal surgery, a prophylactic dose of low-molecular-weight heparin is administered to patients at risk of venous thromboembolic disease, so the initiation of this in the preoperative period may be beneficial in reducing the formation of PAA without the risk of bleeding. as seen in these patients [ 9 ].…”

The incidence of clinically significant venous thromboembolism in an Asian population after major hepatobiliary and pancreatic surgery

“…Studies on Asian patients have shown increased rates of complications in the LMWH group compared to non LMWH group. These ranged from small hematomas and minor ooze to major intra-abdominal and intraluminal bleeding [17,18]. Interestingly though, studies which used LMWH in Asian patients invariably demonstrated a zero rate of symptomatic VTE [13].…”