Key result
Routine thromboprophylaxis in hospitalized medical patients is not warranted due to a high number needed to treat (150-1600) to prevent one symptomatic venous thromboembolism.
Why the study?
Does routine thromboprophylaxis prevent symptomatic venous thromboembolism without excessive bleeding in hospitalised medical patients?
Does routine thromboprophylaxis prevent symptomatic venous thromboembolism without excessive bleeding in hospitalised medical patients?
Effect estimate: NNT 150-1600
Routine thromboprophylaxis in hospitalized medical patients may not be warranted due to a high number needed to treat for symptomatic VTE and offsetting major bleeding risks.
Routine thromboprophylaxis in hospitalised medical patients is based on trials that predominantly use asymptomatic deep vein thrombosis (DVT) as the endpoint. As asymptomatic DVT is 10-30-fold more common than symptomatic DVT, this exaggerates estimates of benefit and cost-effectiveness. Based on symptomatic disease, the number needed to treat per venous thromboembolism (VTE) prevented is high (150-1600), and the true cost-effectiveness of thromboprophylaxis for symptomatic event reduction is uncertain. The incidence of major bleeding among patients receiving prophylaxis is at least equal to the reduction in clinical VTE. Routine thromboprophylaxis in hospitalised medical patients is not warranted, and better patient selection is needed.
No takes yet. Share an insight, caveat, or question.
J. A. Millar (2008) conducted an editorial in Hospitalised medical patients. Routine thromboprophylaxis was evaluated on Symptomatic venous thromboembolism (VTE) (NNT 150-1600). Routine thromboprophylaxis in hospitalized medical patients is not warranted due to a high number needed to treat (150-1600) to prevent one symptomatic venous thromboembolism.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: