Prophylaxis of venous thromboembolism in hospitalized medical patients

Abstract

Because of the great variability and lack of specificity of symptoms of deep vein thrombosis (DVT) and pulmonary embolism (PE) they often remain unrecognized. These factors result in marked underestimation of the venous thromboembolism (VTE) incidence. The VITAE (Venous Thrombo-Embolism Impact Assessment Group in Europe) study estimated the annual number of DVT events in 2004 across 25 EU countries to measure up to 684,000 cases, PE events - 435,000 cases and annual number of death due to VTE 543 000 cases. Extrapolating the VITAE model, about 56,000 symptomatic DVT events and 35,000 symptomatic PE events occur yearly in Poland alone. The ENDORSE study, a cross-sectional survey of 68 183 patients hospitalized in 32 countries has shown that 42,3% of medical patients would benefit of antithrombotic prophylaxis. In Polish hospitals only 35% of medical patients who would benefit, receive the proper antithrombotic prophylaxis. The purpose of this article is to focus on currently available and validated methods of VTE prophylaxis in medical patients. It summarizes data published by the American College of Chest Physicians and review of the practice guidelines for antithrombotic prophylaxis in Poland.