Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients
Authors: David K. Cundiff
Journal: Annals of Internal Medicine (2012)

Letters20 March 2012Venous Thromboembolism Prophylaxis in Hospitalized Medical PatientsDavid K. Cundiff, MD (retired)David K. Cundiff, MD (retired)From LA County USC Medical Center, Long Beach, CA 90814.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-6-201203200-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The background review by Lederle and colleagues (1) and the clinical guidelines by Qaseem and the ACP Clinical Guidelines Committee (2) concluded that heparin prophylaxis for medical patients does not reduce mortality, yet it does increase the risk for major bleeding. In addition, heparin prophylaxis hurts patients with repeated needle sticks and subcutaneous hematomas, takes valuable clinician time, and costs money. Heparin significantly reduces the risk for asymptomatic PE and DVT but not for symptomatic VTE. The ACP recommends that physicians prescribe heparin if the risk for VTE is greater than the risk for bleeding. However, there ...References1. Lederle FA, Zylla D, MacDonald R, Wilt TJ. Venous thromboembolism prophylaxis in hospitalized medical patients and those with stroke: a background review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2011;155:602-15. [PMID: 22041949] LinkGoogle Scholar2. Qaseem A, Chou R, Humphrey LL, Starkey M, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Venous thromboembolism prophylaxis in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011;155:625-32. [PMID: 22041951] LinkGoogle Scholar3. Cundiff DK, Agutter PS, Malone PC, Pezzullo JC. Diet as prophylaxis and treatment for venous thromboembolism? Theor Biol Med Model. 2010;7:31. [PMID: 20701748] CrossrefMedlineGoogle Scholar4. Goldhaber SZ, Dunn K, MacDougall RC. New onset of venous thromboembolism among hospitalized patients at Brigham and Women's Hospital is caused more often by prophylaxis failure than by withholding treatment. Chest. 2000;118:1680-4. [PMID: 11115458] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From LA County USC Medical Center, Long Beach, CA 90814.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVenous Thromboembolism Prophylaxis in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Roger Chou , Linda L. Humphrey , Melissa Starkey , Paul Shekelle , and Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients and Those With Stroke: A Background Review for an American College of Physicians Clinical Practice Guideline Frank A. Lederle , Dylan Zylla , Roderick MacDonald , and Timothy J. Wilt Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients Amir Qaseem , Roger Chou , Linda Humphrey , and Paul Shekelle Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients Graham Mills Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients Paul S. Agutter and P. Colm Malone Metrics 20 March 2012Volume 156, Issue 6Page: 473-474KeywordsAnticoagulantsChartsHemorrhageHeparinObstetrics and gynecologyOrthopedicsProphylaxisStrokeVenous thromboembolism ePublished: 20 March 2012 Issue Published: 20 March 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...