Estimated that in the absence of thrombophylaxis deep vein thrombosis, with potential for fatal pulmonary embolism, will develop in 40 to 60% of medical patients undergoing major orthopedic surgery (Geerts WH et al).
In a retrospective review of 6833 autopsies, 81% of fatal cases of pulmonary embolism occurred in non-surgical patients (Alikan R et al).
Pharmacologic thrombophylaxis reduces venous thromboembolism in both surgical and acutely ill medical patients.
Thrombophylaxis reduces incidence of fatal pulmonary embolism and rate of death from any cause in surgical patients.
In medical patients thrombophylaxis reduces the rate of venous thrombotic events, including asymptomatic DVT.
Meta-analyses of five studies of medical patients indicated thrombophylaxis reduces the rate of fatal PE, but not the rate of death from any cause (Dentali F Et al).
In a double-blind, placebo-controlled, randomized trial assessing subcutaneous enoxaparin 40 mg dailyas compared to placebo in a total of 8307 patients randomized to a Knox apparent with compression stockings, or placebo, with compression stockings: administration of treatments was for 10+ or -4 days-the rate of death from any cause was 4.9% at 30 days in the Enoxaparin group and 4.8% in the placebo group, with a rate of major bleeding of 0.4%, and .3%, respectively. The conclusion of the study was that the use of enoxaparin plus elastic stockings and graduated compression, as compared with elastic stockings with graduated compression alone was not associated with a reduction in the rate from any cause among hospitalized acutely ill medical patients ( LIFENOX). It is 22