Extended Out-of-Hospital Low-Molecular-Weight Heparin for Prophylaxis against Deep Venous Thrombosis
Authors: Naoko Murashige, Roslyn F. Schneider
Journal: Annals of Internal Medicine (2002)

Letters1 October 2002Extended Out-of-Hospital Low-Molecular-Weight Heparin for Prophylaxis against Deep Venous ThrombosisNaoko Murashige, MD and Roslyn F. Schneider, MDNaoko Murashige, MDNational Cancer Center Hospital; Tokyo 104-0045, Japan (Murashige)Beth Israel Medical Center; New York, NY 10003 (Schneider)Search for more papers by this author and Roslyn F. Schneider, MDNational Cancer Center Hospital; Tokyo 104-0045, Japan (Murashige)Beth Israel Medical Center; New York, NY 10003 (Schneider)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-7-200210010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The meta-analysis by Hull and colleagues (1) on extended out-of-hospital low-molecular-weight-heparin (LMWH) for postoperative prophylaxis against deep venous thrombosis (DVT) is provocative, and important questions should be raised about its recommendations. The safety of extended prophylaxis remains uncertain.Hull and colleagues found a low rate of bleeding complications. However, the patients involved had been screened and were followed under study circumstances. The patients who are at highest risk for postoperative DVT are usually those who are most frail and have comorbid conditions that increase risk for bleeding. Many patients also have reduced renal clearance of LMWH because ...References1. Hull RD, Pineo GF, Stein PD, Mah AF, MacIsaac SM, Dahl OE, et al . Extended out-of-hospital low-molecular-weight heparin prophylaxis against deep venous thrombosis in patients after elective hip arthroplasty: a systematic review. Ann Intern Med. 2001;135:858-69. [PMID: 11712876] LinkGoogle Scholar2. Ginsberg JS, Greer I, Hirsh J. Use of antithrombotic agents during pregnancy. Chest. 2001;119:122S-131S. [PMID: 11157646] CrossrefMedlineGoogle Scholar3. Hirsh J, Warkentin TE, Shaughnessy SG, Anand SS, Halperin JL, Raschke R, et al . Heparin and low-molecular-weight heparin: mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety. Chest. 2001;119:64S-94S. [PMID: 11157643] CrossrefMedlineGoogle Scholar4. Muir JM, Hirsh J, Weitz JI, Andrew M, Young E, Shaughnessy SG. A histomorphometric comparison of the effects of heparin and low-molecular-weight heparin on cancellous bone in rats. Blood. 1997;89:3236-42. [PMID: 9129028] CrossrefMedlineGoogle Scholar5. Warkentin TE, Kelton JG. Temporal aspects of heparin-induced thrombocytopenia. N Engl J Med. 2001;344:1286-92. [PMID: 11320387] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Cancer Center Hospital; Tokyo 104-0045, Japan (Murashige)Beth Israel Medical Center; New York, NY 10003 (Schneider) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoExtended Out-of-Hospital Low-Molecular-Weight Heparin Prophylaxis against Deep Venous Thrombosis in Patients after Elective Hip Arthroplasty Russell D. Hull , Graham F. Pineo , Paul D. Stein , Andrew F. Mah , Susan M. MacIsaac , Ola E. Dahl , Matthew Butcher , Rollin F. Brant , William A. Ghali , David Bergqvist , and Gary E. Raskob Extended Out-of-Hospital Low-Molecular-Weight Heparin for Prophylaxis against Deep Venous Thrombosis Russell D. Hull , Graham F. Pineo , and Andrew F. Mah Metrics 1 October 2002Volume 137, Issue 7Page: 620-621KeywordsBoneBone densityDeep vein thrombosisHemorrhageHeparinHeparin-induced thrombocytopeniaLow molecular weight heparinProphylaxisRenal diseasesSafety ePublished: 1 October 2002 Issue Published: 1 October 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...