PMID- 22648489
OWN - NLM
STAT- MEDLINE
DCOM- 20121022
LR  - 20120531
IS  - 1098-9048 (Electronic)
IS  - 1069-3424 (Linking)
VI  - 33
IP  - 2
DP  - 2012 Apr
TI  - Thromboprophylaxis in surgical and medical patients.
PG  - 163-75
LID - 10.1055/s-0032-1311795 [doi]
AB  - Venous thromboembolism (VTE) remains the most common preventable cause of death 
      in hospitalized patients. There is much evidence to show the efficacy of 
      prophylactic strategies to prevent VTE in at-risk hospitalized patients. For 
      example, pharmacological prophylaxis reduces the risk of pulmonary embolism by 
      75% in general surgical patients and by 57% in medical patients. Thus 
      international guidelines strongly recommend effective preventive strategies for 
      all hospitalized patients defined as moderate to high risk for VTE. Effective 
      pharmacological thromboprophylaxis includes low-dose unfractionated heparin 
      (UFH), low molecular weight heparin (LMWH), fondaparinux, and warfarin. 
      Mechanical prophylaxis with graduated compression stockings and intermittent 
      pneumatic compression is also recommended as an alternative or in combination 
      with pharmacological prophylaxis. Although the volume of evidence supporting the 
      use of thromboprophylaxis is growing, the number of patients receiving adequate 
      prophylaxis is not. Several studies have shown that nearly half of the patients 
      undergoing major surgery or hospitalized for medical illnesses do not receive 
      appropriate antithrombotic prophylaxis. Reducing the discrepancy between 
      evidence-based recommendations and clinical practice seems to be a cost-effective 
      goal. Developing and promoting local protocols and educational activities to 
      encourage prophylaxis in daily clinical practice may be effective. New oral 
      anticoagulant drugs with potentially favorable pharmacokinetic and 
      pharmacodynamic characteristics have been developed. After the positive results 
      of phase 3 clinical trials, some of these drugs have been approved for clinical 
      use in the prevention of VTE in the high-risk setting of major orthopedic 
      surgery. These agents include the direct thrombin inhibitor dabigatran etexilate 
      and the direct factor Xa inhibitors rivaroxaban and apixaban.
CI  - Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
FAU - Bozzato, Silvia
AU  - Bozzato S
AD  - Department of Clinical Medicine, University of Insubria-Varese, U.O. Medicina I, 
      Ospedale di Circolo,Viale Borri 57, Varese, Italy
FAU - Galli, Luca
AU  - Galli L
FAU - Ageno, Walter
AU  - Ageno W
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20120530
PL  - United States
TA  - Semin Respir Crit Care Med
JT  - Seminars in respiratory and critical care medicine
JID - 9431858
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anticoagulants/administration & dosage/pharmacology/*therapeutic use
MH  - Combined Modality Therapy
MH  - Evidence-Based Medicine/methods
MH  - Hospitalization
MH  - Humans
MH  - Intermittent Pneumatic Compression Devices
MH  - Postoperative Complications/prevention & control
MH  - *Practice Guidelines as Topic
MH  - Risk Factors
MH  - Stockings, Compression
MH  - Surgical Procedures, Operative/methods
MH  - Venous Thromboembolism/etiology/*prevention & control
EDAT- 2012/06/01 06:00
MHDA- 2012/10/23 06:00
CRDT- 2012/06/01 06:00
PHST- 2012/06/01 06:00 [entrez]
PHST- 2012/06/01 06:00 [pubmed]
PHST- 2012/10/23 06:00 [medline]
AID - 10.1055/s-0032-1311795 [doi]
PST - ppublish
SO  - Semin Respir Crit Care Med. 2012 Apr;33(2):163-75. doi: 10.1055/s-0032-1311795. 
      Epub 2012 May 30.