Prevention Of VTE In Nonsurgical Patients

Publication Date: February 1, 2012
Last Updated: March 14, 2022

Recommendations

Hospitalized Acutely Ill Medical Patients

For acutely ill hospitalized medical patients at increased risk of thrombosis, we recommend anticoagulant thromboprophylaxis With LMWH, LDUH bid, LDUH tid, or fondaparinux. (1, B)
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For acutely ill hospitalized medical patients at low risk of thrombosis ( Table 2 ), we recommend against the use of pharmacologic prophylaxis or mechanical prophylaxis. (1, B)
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For acutely ill hospitalized medical patients who are bleeding or at high risk for bleeding, we recommend against anticoagulant thromboprophylaxis. (1, B)
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For acutely ill hospitalized medical patients at increased risk of thrombosis who are bleeding or at high risk for major bleeding, we suggest.
  • the optimal use of mechanical thromboprophylaxis with graduated compression stockings (GCS)
(2, C)
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  • or intermittent pneumatic compression (IPC),
(2, C)
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  • rather than no mechanical thromboprophylaxis. When bleeding risk decreases, and if VTE risk persists, we suggest that pharmacologic thromboprophylaxis be substituted for mechanical thromboprophylaxis.
(2, B)
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In acutely ill hospitalized medical patients who receive an initial course of thromboprophylaxis, we suggest against extending the duration of thromboprophylaxis beyond the period of patient immobilization or acute hospital stay. (2, B)
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Overview

Title

Prevention Of VTE In Nonsurgical Patients

Authoring Organization

American College of Chest Physicians