Chemoprophylaxis Plus Early Ambulation
Condition: Pulmonary Embolism; Thoracic Surgery
MeSH terms: Pulmonary Embolism; Embolism
Intervention: Chemoprophylaxis with Low Molecular Weight Heparin (LMWH)
Intervention description: Early chemoprophylaxis means low-molecular weight heparin (LMWH) 3075 IU (WHO Units) injection subcutaneously one time a day no later than 24 hours after surgery. Early ambulation means activity out of bed no later than 24 hours after surgery. According to different risk level, patients received different thromboprophylaxis strategies. Early ambulation alone was for patients at low risk (Caprini 0-4), early chemoprophylaxis plus early ambulation was for patients at moderate (Caprini 5-8) or high risk (Caprini ≥9).
Intervention MeSH terms: Heparin; Heparin, Low-Molecular-Weight; Tinzaparin; Dalteparin
Phase: Phase 4
Study type: Interventional
Primary purpose: Prevention
Intervention model: Single Group Assignment
Intervention model description: Early chemoprophylaxis means low-molecular weight heparin (LMWH) 3075 IU (WHO Units) injection subcutaneously one time a day no later than 24 hours after surgery. Early ambulation means activity out of bed no later than 24 hours after surgery. According to different risk level, patients received different thromboprophylaxis strategies. Early ambulation alone was for patients at low risk (Caprini 0-4), early chemoprophylaxis plus early ambulation was for patients at moderate (Caprini 5-8) or high risk (Caprini ≥9).
Masking: None (Open Label)
Enrollment: 581.0
Sex: All
Minimum age: 14 Years
Maximum age: 80 Years
Healthy volunteers: No
Keywords: Pulmonary embolism; Thoracic surgery; Thromboprophylaxis

Summary:

      Pulmonary embolism (PE) can be a devastating postoperative complication and the leading cause
      of mortality after thoracic surgery. PE together with deep venous thrombosis (DVT) is called
      venous thromboembolism (VTE), whereas PE caused much more serious situation than DVT. Huge
      amount of data have demonstrated that thromboprophylaxis after surgery is very important to
      prevent postoperative VTE, especially after orthopedic surgery and plaster surgery. Moreover,
      for thoracic surgery, American College of Chest Physicians (ACCP) has published prevention
      guidelines of VTE in non-orthopedic surgical patients and has been used widely, but
      unfortunately prophylaxis measures had often been underused in China. However, to be honest,
      there could be a big difference between Chinese and western populations, for example, what
      guidelines recommended thrombolysis therapy in diagnosed massive or sub-massive PE patients
      is tissue type plasminogen activator (t-PA) 100 mg, while in China 50 mg has the same effect.
      So investigators wanted to establish if the prophylaxis measures what they were using
      currently are suitable for Chinese thoracic surgical patients.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Lung surgical patients who were sent to thoracic postoperative intensive care unit
             (ICU) ward right after surgery and stayed in ICU for at least 24 hours.

        Exclusion Criteria:

          -  Cases received inferior vena filter and anti-coagulation treatment history.