Thromboprophylaxis with dalteparin in medical patients: which patients benefit?
Key result
Dalteparin reduced the risk of venous thromboembolism across all subgroups of acutely ill hospitalized medical patients, including those with congestive heart failure (RR 0.73).
Why the study?
Does subcutaneous dalteparin reduce the composite of symptomatic DVT, pulmonary embolism, asymptomatic proximal DVT, or sudden death in acutely ill hospitalized medical patients?
Population
3,706 patients aged ≥40 years with an acute medical condition requiring hospitalization for at least 4 days…
Comparison
Subcutaneous dalteparin 5000 IU once daily vs Placebo once daily
Design
Cohort
Authors
Discussion
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Overview
Dalteparin was associated with lower VTE risk across subgroups; extends observational data but should not change practice without RCTs.
Study Design
Type
RCT (n=3,706)
Structured PICO
Does subcutaneous dalteparin reduce the composite of symptomatic DVT, pulmonary embolism, asymptomatic proximal DVT, or sudden death in acutely ill hospitalized medical patients?
P
Population
3,706 patients aged ≥40 years hospitalized for an acute medical condition for at least 4 days, receiving dalteparin or placebo.
I
Intervention
Subcutaneous dalteparin 5000 IU once daily
C
Comparator
Placebo once daily
O
Outcome
Composite of symptomatic deep vein thrombosis (DVT), pulmonary embolism, asymptomatic proximal DVT, or sudden deathcomposite
Thromboprophylaxis with dalteparin provides consistent benefits across various subgroups of acutely ill hospitalized medical patients, supporting its broad application.
Limitations
- Retrospective, post hoc analysis
Cite This Study
Cohen et al. (2007) conducted an RCT in acute medical condition requiring hospitalization (n=3,706). Dalteparin vs. Placebo was evaluated on composite of symptomatic deep vein thrombosis (DVT), pulmonary embolism, asymptomatic proximal DVT, or sudden death. Dalteparin reduced the risk of venous thromboembolism across all subgroups of acutely ill hospitalized medical patients, including those with congestive heart failure (RR 0.73).