Francesco Dentali, MD; Monica Gianni, MD; Alessandro Squizzato, MD
Potential Conflicts of Interest: None disclosed.
Dentali F., Gianni M., Squizzato A.; Extended-Duration Venous Thromboembolism Prophylaxis for Medical Patients. Ann Intern Med. 2010;153:688. doi: 10.7326/0003-4819-153-10-201011160-00018
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Published: Ann Intern Med. 2010;153(10):688.
TO THE EDITOR:
In the large randomized, controlled trial (RCT) by Hull and colleagues (1), extended-duration prophylaxis with subcutaneous enoxaparin compared with short-duration prophylaxis reduced the incidence of the primary efficacy end point (the composite of symptomatic or asymptomatic deep venous thrombosis, symptomatic pulmonary embolism, or fatal pulmonary embolism) in patients requiring total bed rest or who were sedentary without bathroom privileges, patients older than 75 years, and women. In contrast, the primary safety end point (major hemorrhagic complications during and up to 48 hours after the double-blind treatment) was significantly greater in the extended-duration enoxaparin group than in the placebo group, although the observed absolute differences in risk for VTE and major bleeding events suggest a favorable benefit–risk ratio in these patients.
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