Deep Vein Thrombosis and Pulmonary Embolism: A Shared Postoperative Concern in Prolonged Immobilised Patients

Abstract

Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a major preventable cause of morbidity and mortality among postoperative and prolonged immobilized patients. Despite advances in surgical care, anesthesia, and anticoagulant therapy, VTE continues to be a significant global health challenge. Postoperative immobility, endothelial injury, and hypercoagulability—collectively known as Virchow’s triad—remain the cornerstone mechanisms driving thrombus formation. Surgical stress, tissue trauma, and prolonged bed rest further exacerbate venous stasis and clot propagation. Clinically, DVT often presents with unilateral leg swelling and pain, while PE manifests with dyspnea, chest pain, or hemodynamic instability, although many cases remain asymptomatic until complications arise. Early diagnosis through clinical scoring systems, D-dimer assays, ultrasonography, and computed tomography pulmonary angiography is crucial to prevent fatal outcomes. Preventive strategies, including pharmacologic prophylaxis with heparins or direct oral anticoagulants, mechanical compression, and early mobilization, have proven highly effective. However, variations in clinical practice, underdiagnosis, and inadequate adherence to prophylactic protocols persist, particularly in resource-limited settings. Future research should emphasize risk-based individualized prevention, development of national guidelines, and incorporation of artificial intelligence for improved prediction and early detection. A multidisciplinary approach integrating clinicians, nurses, and physiotherapists is essential to minimize postoperative VTE burden and improve patient outcomes.