What is the most suitable anticoagulation strategy for a patient who recently underwent surgery and is at risk for thromboembolism?

The most suitable anticoagulation strategy for a patient who recently underwent surgery and is at risk for thromboembolism is the initiation of low molecular weight heparin (LMWH) as soon as possible. This approach allows for immediate thrombo-prophylaxis, which is crucial in preventing deep vein thrombosis (DVT) and pulmonary embolism (PE), especially in patients who have undergone surgery and may have limited mobility during their recovery.

LMWH has a predictable pharmacokinetic profile and is associated with lower rates of major bleeding complications compared to unfractionated heparin, making it a preferred choice. Furthermore, LMWH can be administered subcutaneously, allowing for ease of use, especially in the postoperative setting. This prompt initiation is critical as it ensures that the patient is protected from thromboembolic events as soon as their clinical condition allows.

Warfarin, while effective for long-term anticoagulation, requires monitoring of INR and takes time to become therapeutic, which delays the necessary protection against thromboembolism. Delaying anticoagulation after surgery could leave patients vulnerable to thrombotic events during the recovery period. Initiating direct oral anticoagulants (DOACs) upon discharge may also not provide adequate immediate