A comparison of thromboembolic prophylaxis in gynecologic oncology patients

M. Ailawadi, G. Del Priore

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The objective of this study was to compare two methods of thromboembolic prophylaxis: sequential compression devices alone (SCDs) vs. SCDs with subcutaneous low-dose unfractionated heparin (UH). A retrospective cohort study was conducted of 168 patients who had undergone surgery for suspected gynecological malignancies. These patients were examined for associated risk factors, method of prophylaxis, and incidence of clinically significant thromboembolic events. Of these patients, 94 (56%) received perioperative and postoperative sequential compression devices alone, while 74 (44%) received both SCDs and subcutaneous low-dose UH. The postoperative course of these patients, while in the hospital and after discharge, was followed for clinically evident thromboembolic complications. Univariate and multivariate analyses were performed. The two groups were comparable in terms of most risk factors, including age, stage, height, weight, body surface area, estimated blood loss, total anesthesia time, and nodal disease. Six of 94 patients (6.4%) in the SCDs group suffered from venous thromboembolism, while four of 74 patients (5.4%) who received both SCDs and low-dose UH had a thromboembolic event (x2 P = 0.79). There was no difference in postoperative changes in platelet counts between the two groups. Heparin added additional cost, 105 extra minutes of nursing time per patient per admission, and additional pain for the patient. In conclusion, the addition of subcutaneous low-dose unfractionated heparin to SCDs for prophylaxis against deep venous thrombosis in women undergoing surgery for gynecologic malignancies does not improve the outcome. Adding heparin was more expensive, time consuming, and painful. Heparin should not be used with SCDs unless an additional benefit can be demonstrated in a randomized controlled trial.

Original languageEnglish (US)
Pages (from-to)354-358
Number of pages5
JournalInternational Journal of Gynecological Cancer
Volume11
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Heparin
Equipment and Supplies
Gynecologic Surgical Procedures
Patient Admission
Body Surface Area
Venous Thromboembolism
Platelet Count
Venous Thrombosis
Neoplasms
Nursing
Cohort Studies
Multivariate Analysis
Anesthesia
Randomized Controlled Trials
Retrospective Studies
Weights and Measures
Costs and Cost Analysis
Pain
Incidence

Keywords

  • Compression devices
  • Heparin
  • Oncology
  • Thromboembolism

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology
  • Cancer Research

Cite this

A comparison of thromboembolic prophylaxis in gynecologic oncology patients. / Ailawadi, M.; Del Priore, G.

In: International Journal of Gynecological Cancer, Vol. 11, No. 5, 2001, p. 354-358.

Research output: Contribution to journalArticle

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