Society for Ambulatory Anesthesia Position Statement on Risk Assessment and Prophylaxis for Prevention of Venous Thromboembolism After Ambulatory Surgery: A Simplified Approach

Niraja Rajan; John George 3rd; Kathy Walsh; Dawn Schell; Girish P Joshi

doi:10.1213/ANE.0000000000008044

Society for Ambulatory Anesthesia Position Statement on Risk Assessment and Prophylaxis for Prevention of Venous Thromboembolism After Ambulatory Surgery: A Simplified Approach

Anesth Analg. 2026 Apr 20. doi: 10.1213/ANE.0000000000008044. Online ahead of print.

Authors

Niraja Rajan¹, John George 3rd², Kathy Walsh³, Dawn Schell², Girish P Joshi⁴

Affiliations

¹ From the Department of Anesthesiology and Perioperative Medicine, Penn State Health, Hershey, Pennsylvania.
² Department of Anesthesiology, The Cleveland Clinic, Cleveland, Ohio.
³ Martin County Surgery Center, Stuart, Florida.
⁴ Department of Anesthesiology and Pain Management, University of Texas Southwestern, Dallas, Texas.

PMID: 42008825
DOI: 10.1213/ANE.0000000000008044

Abstract

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT), pulmonary embolism (PE), and post-thrombotic syndrome (PTS), affects up to 900,000 people in the United States each year and as many as 60,000 to 100,000 of these patients may die. More than half of the VTE events occurring after hospital discharge are directly linked to a recent hospitalization or surgery. Sudden death is the first symptom in 25% of those who experience a PE, so prevention of VTE is of paramount importance. Several professional organizations have published perioperative guidelines for VTE prevention and accreditation organizations have incorporated VTE risk assessment and prophylaxis in their standards. Ambulatory anesthesiologists, by being part of multidisciplinary teams to establish enhanced recovery pathways at their outpatient facilities, play a pivotal role in identifying patients at risk for developing VTE, customizing risk assessment tools, and establishing thromboprophylaxis protocols for patients at their centers. In addition, anesthesiologists can play a key role in patient education, which is an important component of VTE prevention. With increased migration of complex procedures and patients to the outpatient setting, VTE risk in the high-risk groups of patients approaches inpatient levels. This position statement from the Society for Ambulatory Anesthesia (SAMBA) is tailored toward ambulatory surgery centers and summarizes and synthesizes existing VTE risk assessment and prophylaxis tools into an easy-to-use algorithm.