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More than half of hospitalized patients worldwide are at risk for developing venous thromboembolism (VTE), but many aren't receiving appropriate preventive measures.


A study of patients in 32 countries included 37,356 medical patients age 40 and older and 30,827 surgical patients age 18 and older. Researchers used the 2004 American College of Chest Physicians guidelines to assess VTE risk and determine if patients were receiving recommended prophylaxis, which includes using graduated compression stockings or intermittent pneumatic compression devices and anticoagulation. Overall, only about 59% of at-risk surgical patients and 40% of at-risk medical patients received appropriate prophylaxis.


Among at-risk medical patients, those in Germany fared best, with 70% of 479 at-risk patients receiving appropriate prophylaxis. In the United States, only 48% of 2,720 at-risk medical patients received appropriate preventive treatment. The figure for at-risk surgical patients in Germany was 92% of 838 patients, compared with 71% of 3,165 patients in the United States.


Researchers say their findings reinforce "the rationale for the use of hospital-wide strategies to assess patients' VTE risk and to implement measures that ensure that at-risk patients receive appropriate prophylaxis."




Cohen AT, et al., Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE STUDY): A multinational cross-sectional study, Lancet, February 2, 2008.