Preventing venous thromboembolism in acute medical patients.
BACKGROUND
While extensive data support the clinical benefit and cost-effectiveness of routine thromboprophylaxis in surgical patients, the use of this approach in medical patients has been controversial. However, recent data, mainly from the MEDENOX trial, support routine thromboprophylaxis in acutely ill medical patients.


OBJECTIVE
To determine attitudes towards VTE prevention in such patients, in departments of internal medicine in Israel.


METHODS
Questionnaire-based survey.


METHODS
A questionnaire regarding aspects of VTE prophylaxis was mailed to all heads of internal medicine departments in Israel (n = 90). The questionnaire also included data concerning VTE prevention measures in specific acute medical illnesses, based on the MEDENOX study population.


RESULTS
Fifty-eight (64%) departments returned the questionnaire. Forty-seven (81%) of them considered VTE a clinical problem in their departments, but only 37 (63%) had a routine VTE prevention policy. The most frequently used modality for VTE prophylaxis was low-molecular-weight heparin. There was little agreement concerning the exact indications or risk factors in which VTE prophylaxis measures should be used, except the combination of acute medical disabling illness and previous VTE.


CONCLUSIONS
The results emphasize the need for detailed guidelines and risk assessment models for VTE prevention treatments in acutely ill medical patients, as well as better education for physicians.
Elis
A
A
Department of Medicine 'A', Sapir Medical Center, Meir Hospital, 44281 Kfar Saba, Israel. avishayel@clalit.org.il
Ellis
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MH
D000208:Acute Disease; D001172:Arthritis, Rheumatoid / Q000628:therapy; D001291:Attitude of Health Personnel; D003141:Communicable Diseases / Q000628:therapy; D003657:Decision Making; D006333:Heart Failure / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy; D007388:Internal Medicine; D007557:Israel; D012131:Respiratory Insufficiency / Q000628:therapy; D013122:Spinal Diseases / Q000628:therapy; D011795:Surveys and Questionnaires; D013923:Thromboembolism / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control*