Extended VTE prophylaxis in medical patients

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
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.

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