Is in-hospital prophylaxis adequate for the prevention of VTE in acutely ill medical patients?

A recent cohort study shows that VTE attack rates have not changed, despite near-universal use of in-hospital VTE prophylaxisEven though venous thromboembolism is recognized as a major health problem in the United States, our understanding of the actual number of symptomatic VTE events that are potentially preventable and the effects of hospitalization-based prophylaxis on VTE incidence and bleeding is limited.

To address these knowledge gaps, a new population-based cohort study estimates total VTE event rates in the US between 2005 and 2010, both related and unrelated to hospitalization, based on real-world data from Mayo Clinic Hospitals in Olmstead County Minnesota.

This study revealed insights into current standards of care in VTE prophylaxis:

  • Approximately 500,000 US VTE events occur annually; approximately 50% are related to current or recent hospitalization
  • The median duration of in-hospital anticoagulant prophylaxis was 63 hours; the median duration of hospitalization was 3 days
  • 75% of hospitalizations were complicated by an incident or recurrent VTE event within 92 days of discharge
  • Despite near-universal adoption of in-hospital VTE prophylaxis by 2010, VTE attack rates did not change, possibly due to short prophylaxis duration

These results highlight the need to provide longer-duration prophylaxis to individuals who are at high risk for VTE events, both in and out of the hospital.

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