Prevention and management of venous thromboembolism

The risk of venous thromboembolism is significantly increased in patients who are hospitalised after trauma, surgery or immobilising medical illness, and in pregnant and puerperal women.

Remit and target users

The guideline identifies adult patient groups at risk of venous thromboembolism and describes the available methods of prophylaxis, with general recommendations about efficacy, safety, and how they should be used. Appropriate methods of prophylaxis for specific patient groups are considered. Diagnosis of deep vein thrombosis and pulmonary embolism are described, including the use of diagnostic algorithms incorporating D-dimer assay. Recommendations are made on treatment options for thrombosis in various anatomical regions.

This guideline will be of particular interest to medical practitioners in a wide range of specialties including general practice, nurses, pharmacists and dentists.

How this guideline was developed

This guideline was developed using a standard methodology based on a systematic review of the evidence. Further details can be found in SIGN 50: A Guideline Developer’s Handbook.

Keeping up to date

This guideline was issued in 2010 and will be considered for review in three years. The review history, and any updates to the guideline in the interim period, will be noted in the review report.

A minor update has been made in light of the CLOTS3 trial. The updated guidelines recommend that IPC should be considered for use in patients immobilised after a stroke. The section on heparin induced thrombocytopenia has also been updated to reflect changes in drug licensing and to ensure consistency with guidelines produced by the British Committee for Standards in Haematology.

Section 9.2 and Annex 5 revised November 2011

Some recommendations may be out of date, declaration of interests governance may not be in line with current policy.