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Join Date: Apr 2007 Location: kathmandu | | | prophylaxis of venous thromboembolism -
26-07-2007, 04:01 AM
Venous Thromboembolism: Risk and Prophylaxis The current Archives of Internal Medicine carries two studies on venous thromboembolism (VTE) -- one on risk among outpatients and the other on best practices for prophylaxis.
The first study examined the records of some 1900 patients with confirmed VTE and found that almost three-quarters developed the condition as outpatients. It also found, however, that of those outpatients, almost half had been hospitalized or undergone surgery within the preceding 3 months. Among those cases, about two-thirds had developed VTE within a month of hospitalization, and less than half had received anticoagulant prophylaxis during their stay.
The other study was a meta-analysis encompassing some 35 prospective randomized controlled trials of low-molecular-weight heparin or unfractionated heparin in hospitalized patients. Compared with a control, both treatments reduced VTE risk, although neither reduced mortality. In addition, low-molecular-weight heparin was more effective than unfractionated heparin against deep vein thrombosis. The analysis also found that thrice-daily dosing of 5000 U of unfractionated heparin was preferable to twice-daily dosing.
An editorialist observes: "The culture surrounding inpatient VTE prophylaxis is undergoing a transition from optional to mandatory." He predicts that "preventing outpatient VTE will be the 'hot button' issue in 2008."
Archives of Internal Medicine article on VTE risk among outpatients (Free) Archives of Internal Medicine article on VTE prophylaxis in hospitalized patients (Free abstract; full text requires subscription) Archives of Internal Medicine editorial (Subscription required) Share:  Digg this /  Add to del.icio.us /  Add to reddit /  Forward to a Friend | | Thread Tools | | | | Display Modes |  Linear Mode | 
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