Prevention of Venous Thromboembolism, 2nd Edition: Korean Society of Thrombosis and Hemostasis Evidence-Based Clinical Practice Guidelines

Abstract

In 2010, we proposed the first Korean Guidelines for the Prevention of Venous Thromboembolism (VTE). It was applicable to Korean patients, by modifying the contents of the second edition of the Japanese guidelines for the prevention of VTE and the 8th edition of the American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines. From 2007 to 2011, we conducted a nationwide study regarding the incidence of VTE after major surgery using the Health Insurance Review and Assessment Service (HIRA) database. In addition, we have considered the 9th edition of the ACCP Evidenced-Based Clinical Practice Guidelines, published in 2012. It emphasized the importance of clinically relevant events as opposed to asymptomatic outcomes with preferences for both thrombotic and bleeding outcomes. Thus, in the development of the new Korean guidelines, three major points were addressed: 1) the new guidelines stratify patients into 4 risk groups (very low, low, moderate, and high) according to the actual incidence of symptomatic VTE from the HIRA databases; 2) the recommended optimal VTE prophylaxis for each group was modified according to condition-specific thrombotic and bleeding risks; 3) guidelines are intended for general information only, are not medical advice, and do not replace professional medical care and/or physician advice.Graphical Abstract

Portomesenteric vein thrombosis after gastric surgery

“…Routine prophylactic anticoagulation was adopted in our institution following the suggestion of the 2010 ''Korean guideline for the prevention of VTE'' [15,16].…”

The incidence and risk factors for deep vein thrombosis after kidney transplantation in Korea: single‐center experience

“…Recently, the Korean Society of Thrombosis and Hemostasis published guidelines for DVT prevention according to venous thromboembolism (VTE) risk stratification (10). In the guidelines, pharmacological and mechanical prophylaxis is recommended for the prevention of DVT in patients who undergo general abdominal surgery.…”

Legal issues related to postoperative pulmonary thromboembolism in Korea

“…Following the accumulation of evidence suggesting a reduced frequency of PTE after preventive measures, attempts to prevent PTE have increased [18]. PTE prophylaxis and treatment have received increasing attention in surgery [19]. For the treatment of venous thromboembolism (VTE), thromboprophylaxis has been recommended based on the four following factors: the high incidence of VTE in hospitalized patients; the difficulty of early diagnosis due to vague symptomatology; the cost-effectiveness of medical prophylaxis; and the high mortality of PE without early diagnosis and prompt management [20].…”