Amir Qaseem, MD, PhD, MHA; Roger Chou, MD; Linda Humphrey, MD, MPH; Paul Shekelle, MD, PhD
Potential Conflicts of Interest: Any financial and nonfinancial conflicts of interest of the group members were declared, discussed, and resolved. Dr. Humphrey: Consultancy: U.S. Preventive Services Task Force. Royalties: UpToDate. Dr. Shekelle: Consultancy: ECRI Institute; Employment: Department of Veterans Affairs; Grants/grants pending (money to institution): Agency for Healthcare Research and Quality, Department of Veterans Affairs, Centers for Medicare & Medicaid Services; Royalties: UpToDate. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1931.
Qaseem A, Chou R, Humphrey L, Shekelle P. Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients. Ann Intern Med. 2012;156:474-475. doi: 10.7326/0003-4819-156-6-201203200-00020
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Published: Ann Intern Med. 2012;156(6):474-475.
We thank Dr. Mills, Drs. Agutter and Malone, and Dr. Cundiff for their comments regarding the recent clinical guideline on VTE prophylaxis in hospitalized patients.
In response to Dr. Mills, the pooled results from medical patients showed that prophylaxis with heparin is associated with a statistically significant reduction in PEs (absolute decrease, 4 events per 1000 persons treated) but a nonstatistically significant increase in major bleeding events (absolute increase, 1 event per 1000 persons treated) and no effect on mortality or symptomatic DVT. Hence, there is more benefit from potential reduction in PE events relative to the risk for bleeding.
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