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Anticoagulant Prophylaxis in Medical Patients: An Objective Assessment
Author(s) -
Deitelzweig Steven,
Groce James B.
Publication year - 2004
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.24.12.120s.36115
Subject(s) - medicine , pulmonary embolism , intensive care medicine , deep vein , dosing , heparin , thrombosis , fondaparinux , anticoagulant , venous thrombosis , population , epidemiology , placebo , low molecular weight heparin , venous thromboembolism , alternative medicine , environmental health , pathology
Venous thromboembolism (VTE) is a clinically silent and potentially fatal disease that manifests as deep vein thrombosis (DVT) and pulmonary embolism. Venous thromboembolism remains a serious public health challenge, with an ever‐increasing odds ratio of occurrence given the aging population in the United States. This article reviews the epidemiology of VTE; risk factor identification and stratification as a means of advancing awareness, prevention, and detection of VTE; and prophylaxis options and their outcomes, particularly administration of unfractionated heparin (UFH) 5000 U subcutaneously every 12 versus 8 hours in the at‐risk medical patient population. The important studies comparing outcomes of these different UFH dosing regimens compared with placebo and low‐molecular‐weight heparins also are discussed. Consensus recommendations shaping contemporary clinical practice guidelines in this setting are highlighted. A systemwide approach to treatment of all medical patients who are risk stratified and receiving appropriate pharmacologic prophylaxis is recommended.