Pending Surgery

Except for brain or spine surgery, holding chemical VTE prophylaxis prior to surgery is not indicated.

1. Routinely holding pharmacological prophylaxis prior to surgery may increase VTE risk without an accompanying decrease in the risk of bleeding. Many specialties with high DVT rates are now administering chemoprophylaxis at the start of surgery. 29-32
2. A pending invasive procedure is the most common reason for a patient missing a dose of chemoprophylaxis. Every missed dose increases VTE risk. Patients that miss two to four doses are at 8.5 times higher DVT risk compared with those with no missed doses.33