Assessment of venous thromboembolism risk and the benefits of thromboprophylaxis in medical patients.

Published

Journal Article (Review)

Hospitalized patients with acute medical conditions are at significant risk of venous thromboembolism (VTE): approximately 10-30% of general medical patients may develop deep-vein thrombosis or pulmonary embolism, and the latter is a leading contributor to deaths in hospital. Despite consensus-group recommendations that at-risk medical patients should receive thromboprophylaxis, there is currently no consensus as to which patients are at risk, and many patients may not receive appropriate thromboprophylaxis. This paper reviews evidence for the risk of VTE associated with different medical conditions and risk factors, and presents a risk-assessment model for risk stratification in medical patients. Medical conditions associated with a moderate to high risk of VTE include cardiac disease, cancer, respiratory disease, inflammatory bowel disease, and infectious diseases. Importantly, analyses of data from the MEDENOX study show that thromboprophylaxis significantly reduces the risk of VTE in these patient subgroups. Risk factors in medical patients include a history of VTE, history of malignancy, increasing age, thrombophilia, prolonged immobility, and obesity. These medical conditions and risk factors are included in a risk-assessment model which is hoped will provide a simple means of assisting clinicians in deciding whether thromboprophylaxis should be used in an individual patient.

Full Text

Cited Authors

  • Cohen, AT; Alikhan, R; Arcelus, JI; Bergmann, J-F; Haas, S; Merli, GJ; Spyropoulos, AC; Tapson, VF; Turpie, AGG

Published Date

  • October 2005

Published In

Volume / Issue

  • 94 / 4

Start / End Page

  • 750 - 759

PubMed ID

  • 16270626

Pubmed Central ID

  • 16270626

Electronic International Standard Serial Number (EISSN)

  • 2567-689X

International Standard Serial Number (ISSN)

  • 0340-6245

Language

  • eng