Rational thromboprophylaxis in medical inpatients:  not quite there yet

Fletcher, John P; MacLellan, Donald; Gibbs, Harry; Matthews, Geoff

doi:10.5694/j.1326-5377.2009.tb02467.x

Topics

To the Editor: In the 3 November 2008 issue of the Journal, Millar recommends against routine thromboprophylaxis in medical patients.1

1 Western Clinical School, Westmead Hospital, Sydney, NSW.
2 NSW Health, Sydney, NSW.
3 Princess Alexandra Hospital, Brisbane, QLD.
4 Austin and Repatriation Medical Centre, Melbourne, VIC.

Correspondence: johnf@med.usyd.edu.au

Competing interests:

All authors are members of the Australia and Zealand Working Party on the Management and Prevention of Venous Thromboembolism. John Fletcher has received speaker fees and travel assistance from Sanofi-Aventis and GlaxoSmithKline, and a speaker fee from Bayer Schering Pharma. Donald MacLellan has received non-directed educational grants from a number of pharmaceutical and non-pharmaceutical companies, including Sanofi-Aventis, to allay costs in the production of the Prevention of venous thromboembolism booklets. Harry Gibbs has received clinical trial funding, consultancy fees, honoraria and travel grants from a number of pharmaceutical and medical device companies, including Sanofi-Aventis, Pfizer and Boehringer Ingelheim. Geoff Matthews received travel assistance from Sanofi-Aventis.

1. Millar JA. Rational thromboprophylaxis in medical inpatients: not quite there yet. Med J Aust 2008; 189: 504-506. <eMJA full text> <MJA full text>
2. Heit J, O’Fallon M, Petterson T, et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism. Arch Intern Med 2002; 162: 1245-1248.
3. National Institute of Clinical Studies. The incidence and risk factors for venous thromboembolism in hospitals in Western Australia 1999 to 2001. Prepared by the School of Population Health, University of Western Australia. Melbourne: NICS, 2005.
4. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet 2000; 355: 1295-1302.
5. Geerts WH, Bergqvist D, Pineo GF, et al; American College of Chest Physicians. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008; 133 (6 Suppl): 381S-453S.
6. Cardiovascular Disease Educational and Research Trust; Cyprus Cardiovascular Disease Educational and Research Trust; European Venous Forum; International Surgical Thrombosis Forum; International Union of Angiology; Union Internationale de Phlébologie. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according to scientific evidence). Int Angiol 2006; 25: 101-161.
7. Australia and New Zealand Working Party on the Management and Prevention of Venous Thromboembolism. Prevention of venous thromboembolism: best practice guidelines for Australia and New Zealand. 4th ed. Sydney: Health Education and Management Innovations, 2007.

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