Table 1. Risk stratification,... | American Society of Hematology

Table 1.

Risk stratification, recommended thromboprophylaxis and optimal duration of prophylaxis by patient group.

Patient groups	Recommended thromboprophylaxis options*	Optimal duration of prophylaxis
*The recommended options may differ somewhat for specific patient groups based on available evidence. See the 8^th ACCP Guidelines on the Prevention of VTE.¹
GCS indicates graduated compression stocking; PCD, pneumatic compression device, VFP, venous foot pump.
Low VTE Risk:
▪ Medical – fully mobile, brief admission, no additional risk factors ▪ Surgical – procedure < 30 minutes, patient mobile, no additional risk factors	▪ No prophylaxis ▪ Early and frequent ambulation	Not applicable.
Moderate VTE Risk:
▪ Acute medical illness ▪ Major general surgery ▪ Major gynecologic surgery ▪ Major urologic surgery ▪ Thoracic surgery ▪ Bariatric surgery	▪ Low-molecular-weight heparin ▪ Low-dose heparin ▪ Fondaparinux ▪ Combinations of a mechanical method and an anticoagulant	Continue until discharge for the majority of patients. Selected patients may benefit from post-discharge prophylaxis.
High VTE Risk:
▪ Hip or knee arthroplasty ▪ Hip fracture surgery	▪ Low-molecular-weight heparin ▪ Fondaparinux ▪ Rivaroxaban or dabigatran ▪ Warfarin (target INR 2–3)	Minimum of 10 days and up to 35 days.
High VTE Risk:
▪ Major trauma, (including spinal cord injury)	▪ Low-molecular-weight heparin ▪ Combinations of a mechanical method and an anticoagulant	Continue until discharge for the majority of patients. Prophylaxis should be continued for the inpatient rehabilitation period.
High bleeding risk
	▪ Mechanical method of prophylaxis (GCS, PCD, VFP) ▪ Consider anticoagulant prophylaxis when bleeding risk decreases	Duration appropriate for the specific patient risk group.

Patient groups	Recommended thromboprophylaxis options*	Optimal duration of prophylaxis
*The recommended options may differ somewhat for specific patient groups based on available evidence. See the 8^th ACCP Guidelines on the Prevention of VTE.¹
GCS indicates graduated compression stocking; PCD, pneumatic compression device, VFP, venous foot pump.
Low VTE Risk:
▪ Medical – fully mobile, brief admission, no additional risk factors ▪ Surgical – procedure < 30 minutes, patient mobile, no additional risk factors	▪ No prophylaxis ▪ Early and frequent ambulation	Not applicable.
Moderate VTE Risk:
▪ Acute medical illness ▪ Major general surgery ▪ Major gynecologic surgery ▪ Major urologic surgery ▪ Thoracic surgery ▪ Bariatric surgery	▪ Low-molecular-weight heparin ▪ Low-dose heparin ▪ Fondaparinux ▪ Combinations of a mechanical method and an anticoagulant	Continue until discharge for the majority of patients. Selected patients may benefit from post-discharge prophylaxis.
High VTE Risk:
▪ Hip or knee arthroplasty ▪ Hip fracture surgery	▪ Low-molecular-weight heparin ▪ Fondaparinux ▪ Rivaroxaban or dabigatran ▪ Warfarin (target INR 2–3)	Minimum of 10 days and up to 35 days.
High VTE Risk:
▪ Major trauma, (including spinal cord injury)	▪ Low-molecular-weight heparin ▪ Combinations of a mechanical method and an anticoagulant	Continue until discharge for the majority of patients. Prophylaxis should be continued for the inpatient rehabilitation period.
High bleeding risk
	▪ Mechanical method of prophylaxis (GCS, PCD, VFP) ▪ Consider anticoagulant prophylaxis when bleeding risk decreases	Duration appropriate for the specific patient risk group.