In this large randomized trial of high risk hospitalized patients (eg >age 40 with CHF, cancer, or infection with at least 1 other risk factor for VTE), all cause mortality and major bleeding were no different between those receiving LMWH (40 qday) versus graduated compression stockings. Although this study was not designed to evaluate rate of asymptomatic or symptomatic VTE, there was only 1 fatal PE in each group. The caveats are that this international population had lower risk of VTE than past US study populations (lower rate of a past history of VTE, lower BMI), but nonetheless, mortality and bleeding did not differ between LMWH and stockings in these population of hospitalized medical patients (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.