RT Journal Article
SR Electronic
T1 Prevention of venous thromboembolism in the hospitalized medical patient
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP S7
OP S16
VO 75
IS 4 suppl 3
A1 Amir K. Jaffer
A1 Alpesh N. Amin
A1 Daniel J. Brotman
A1 Steven B. Deitelzweig
A1 Sylvia C. McKean
A1 Alex C. Spyropoulos
YR 2008
UL http://www.ccjm.org/content/75/4_suppl_3/S7.abstract
AB Hospitalized acutely ill medical patients are at high risk for venous thromboembolism (VTE), and clinical trials clearly demonstrate that pharmacologic prophylaxis of VTE for up to 14 days significantly reduces the incidence of VTE in this population. Guidelines recommend use of low-molecular-weight heparin (LMWH) or unfractionated heparin (5,000 U three times daily) for VTE prophylaxis in hospitalized medical patients with risk factors for VTE; in patients with contraindications to anticoagulants, mechanical prophylaxis is recommended. All hospitalized medical patients should be assessed for their risk of VTE at admission and daily thereafter, and those with reduced mobility and one or more other VTE risk factors are candidates for aggressive VTE prophylaxis. Based on results from the recently reported EXCLAIM trial, extended post-discharge prophylaxis with LMWH for 28 days should be considered for hospitalized medical patients with reduced mobility who are older than age 75 or have a cancer diagnosis or a history of VTE.