Anticoagulant Prophylaxis for Hospitalized Medical Patients
Authors: Mark A. Crowther, Francesco Dentali, Wendy Lim, James D. Douketis
Journal: Annals of Internal Medicine (2007)

Letters2 October 2007Anticoagulant Prophylaxis for Hospitalized Medical PatientsMark A. Crowther, MD, MSc, Francesco Dentali, MD, Wendy Lim, MD, and James D. Douketis, MDMark A. Crowther, MD, MScFrom McMaster University, Hamilton, Ontario L8N 3Z5, Canada.Search for more papers by this author, Francesco Dentali, MDFrom McMaster University, Hamilton, Ontario L8N 3Z5, Canada.Search for more papers by this author, Wendy Lim, MDFrom McMaster University, Hamilton, Ontario L8N 3Z5, Canada.Search for more papers by this author, and James D. Douketis, MDFrom McMaster University, Hamilton, Ontario L8N 3Z5, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-7-200710020-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Lederle and associates question our conclusion that symptomatic VTE in medical patients is reduced during treatment with prophylactic anticoagulants. We acknowledge that a discussion of these matters is important, because our findings could influence the care of many patients.First, they indicate that Cohen and colleagues (1) did not confirm all fatal PEs with autopsy. They propose that this would overestimate the risk for such events. We included these events because, in accordance with our prespecified criteria, they were independently adjudicated as fatal PEs.Second, they questioned our decision to extract data from only the first 21 ...References1. Cohen AT, Davidson BL, Gallus AS, Lassen MR, Prins MH, Tomkowski W, et al. Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. BMJ. 2006;332:325-9. [PMID: 16439370] CrossrefMedlineGoogle Scholar2. Gärdlund B. Randomised, controlled trial of low-dose heparin for prevention of fatal pulmonary embolism in patients with infectious diseases. The Heparin Prophylaxis Study Group. Lancet. 1996;347:1357-61. [PMID: 8637340] CrossrefMedlineGoogle Scholar3. Mahé I, Bergmann JF, d'Azémar P, Vaissie JJ, Caulin C. Lack of effect of a low-molecular-weight heparin (nadroparin) on mortality in bedridden medical in-patients: a prospective randomised double-blind study. Eur J Clin Pharmacol. 2005;61:347-51. [PMID: 15981008] CrossrefMedlineGoogle Scholar4. Mismetti P, Laporte-Simitsidis S, Tardy B, Cucherat M, Buchmüller A, Juillard-Delsart D, et al. Prevention of venous thromboembolism in internal medicine with unfractionated or low-molecular-weight heparins: a meta-analysis of randomised clinical trials. Thromb Haemost. 2000;83:14-9. [PMID: 10669147] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From McMaster University, Hamilton, Ontario L8N 3Z5, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Anticoagulant Prophylaxis to Prevent Symptomatic Venous Thromboembolism in Hospitalized Medical Patients Francesco Dentali , James D. Douketis , Monica Gianni , Wendy Lim , and Mark A. Crowther Anticoagulant Prophylaxis for Hospitalized Medical Patients Frank A. Lederle , Roderick MacDonald , and Timothy J. Wilt Metrics 2 October 2007Volume 147, Issue 7Page: 524KeywordsAnticoagulantsAutopsyConflicts of interestDeep vein thrombosisForecastingProphylaxisResearch design ePublished: 2 October 2007 Issue Published: 2 October 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...