Venous thromboembolism in medically ill patients: identifying risk and strategies for prevention

Venous thromboembolism (VTE) is a condition that has multiple causes but few warning signs. Consequently, the 2 manifestations of VTE-pulmonary embolism and deep vein thrombosis-often go unpredicted. This is especially true for medical patients. Treatment guidelines indicate that most hospitalized patients should receive prophylaxis for VTE. This report discusses these guidelines, the high prevalence of VTE among medical patients, and clinical studies of thromboprophylaxis in medically ill patients. VTE prophylaxis continues to be underutilized in medically ill patients. These patients are at significant risk of VTE and require prophylaxis, an objective that is supported by the recent guidelines of the American College of Chest Physicians. In addition, several lines of clinical evidence support the use of prophylaxis in this subgroup of patients. Improved systems are needed in medically ill patients to help improve outcomes and compliance for the use of VTE prophylaxis.