NCCN Practice Guidelines in VTE Disease At Risk Population Initial Prophylaxis http://www.nccn.org/professionals/physician_gls/PDF/vte.pdf Adult patient Adult patient Diagnosis or clinical suspicion of cancer Diagnosis or clinical suspicion of cancer Inpatient Inpatient Relative contra- indication to anticoagulation treatment Prophylactic anticoagulation therapy (category 1) + sequential compression device (SCD) Mechanical prophylaxis (options) - SCD - Graduated compression stockings NO YES RISK FACTOR ASSESSMENT Age Age Prior VTE Familial thrombophilia Active cancer Trauma Major surgical procedures Acute or chronic medical illness requiring hospitalization or prolonged bed rest Central venous catheter/IV catheter Congestive heart failure Pregnancy Regional bulky lymphadenopathy with extrinsic vascular compression AGENTS ASSOCIATED WITH INCREASED RISK Chemotherapy Chemotherapy Exogenous estrogen compounds Exogenous estrogen compounds - HRT - Oral contraceptives - Tamoxifen/Raloxifene - Diethystilbestrol Thalidomide/lenalidomide Thalidomide/lenalidomide Modifiable risk factors: Lifestyle, smoking, tobacco, obesity, activity level/exercise Continue Prophylaxis After Discharge
{}