Extended VTE prophylaxis in medical patients

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By  |  July 6, 2010 | 

Extended VTE prophylaxis in surgical patients is beneficial, but the appropriate duration of VTE prophylaxis in medical inpatients is unknown. In this large multi-national industry-sponsored trial, acutely ill medical patients >age 40 with limited mobility (bedrest OR bathroom privileges with another VTE risk factor) were randomized to enoxaparin 40mg/day for a month (after open label enoxaparin for 10-14 days). Extended VTE prophylaxis significantly reduced the risk of VTE (2.5% vs 4%), but at the expense of higher rates of bleeding (0.8% vs 0.3%). The subgroups that benefitted the most from extended prophylaxis were women, those >age 75, and those on bedrest (abstract). There was no benefit for extended prophylaxis in those with bathroom privileges, unless they had another VTE risk factor (age >75, cancer, or history of VTE).

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About the Author: Danielle Scheurer

Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as 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 is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.

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