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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Tuesday, December 6, 2011

ACP Guideline: Profilaxis de TEV

Venous Thromboembolism Prophylaxis in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians

Amir Qaseem, MD, PhD, MHA; Roger Chou, MD; Linda L. Humphrey, MD, MPH; Melissa Starkey, PhD; and Paul Shekelle, MD, PhD, for the

Clinical Guidelines Committee of the American College of Physicians*
Ann Intern Med. 2011; 155: 625-632
Randomized trials of heparin versus no heparin therapy for medical patients did not show a statistically significant reduction in the risk for mortality or symptomatic DVT and showed an increased risk for bleeding events. However, PE was significantly reduced in medical patients. For patients with acute stroke, heparin increased the risk for major bleeding, with no effect on mortality, symptomatic DVT, or PE. Studies comparing LMWH with UFH did not show any differences in clinical outcomes. Mechanical prophylaxis was not associated with an improvement in clinical outcomes in patients with acute stroke and resulted in an increased risk for lower-extremity skin damage, although evidence on the effects of mechanical prophylaxis was sparse.