Importance Venous thromboembolism (VTE) is the most preventable cause of morbidity and mortality in US hospitals, and approximately 2.5% of emergency general surgery (EGS) patients will be diagnosed with a VTE event. Emergency general surgery patients are at increased risk of morbidity and mortality because of the nature of acute surgical conditions and the challenges related to prophylaxis.

Observations MEDLINE, Embase, and the Cochrane Database of Collected Reviews were searched from January 1, 1990, through December 31, 2015. Nearly all operatively and nonoperatively treated EGS patients have a moderate to high risk of developing a VTE, and individual risk should be assessed at admission. Pharmacologic prophylaxis in the form of unfractionated or low-molecular-weight heparin should be considered unless an absolute contraindication, such as bleeding, exists. Patients should receive the first dose at admission to the hospital, and administration should continue until discharge without missed doses. Certain patient populations, such as those with malignant tumors, may benefit from prolonged VTE prophylaxis after discharge. Mechanical prophylaxis should be considered in all patients, particularly if pharmacologic prophylaxis is contraindicated. Studies that specifically target improved adherence with VTE prophylaxis in EGS patients suggest that efficacy and quality improvement initiatives should be undertaken from a system and institutional perspective.

Conclusions and Relevance Operatively and nonoperatively treated EGS patients are at a comparatively high risk of VTE. Despite gaps in existing literature with respect to this increasing patient population, successful best practices can be applied. Best practices include assessment of VTE risk, optimal prophylaxis, and physician, nurse, and patient education regarding the use of mechanical and pharmacologic VTE prophylaxis and institutional policies.

重要性 静脉血栓栓塞症（VTE）是美国医院中发病率和死亡率最可预防的原因，大约2.5％的紧急普外科（EGS）患者将被诊断出VTE事件。由于急性外科疾病的性质以及与预防相关的挑战，急诊普外科患者的发病和死亡风险增加。

观察结果 自1990年1月1日至2015年12月31日，对MEDLINE，Embase和Cochrane收集的评价数据库进行了检索。几乎所有接受手术和非手术治疗的EGS患者都有中度到高风险发生VTE，应评估个体风险入场时。除非存在绝对禁忌症（例如出血），否则应考虑以普通肝素或低分子量肝素的形式进行药物预防。患者应在入院时接受第一剂，并应继续给药直至出院而没有遗漏剂量。某些患者人群，例如患有恶性肿瘤的人群，可能会因出院后长期预防VTE而受益。所有患者均应考虑机械预防，特别是在禁忌药物治疗的情况下。

结论和相关性 手术和非手术治疗的EGS患者发生VTE的风险较高。尽管现有文献在增加患者人数方面存在空白，但仍可以应用成功的最佳实践。最佳实践包括评估VTE风险，最佳预防措施，以及有关机械和药理性VTE预防措施和机构政策使用的医师，护士和患者教育。