Prophylactic Anticoagulation Reduces Clots, Not Deaths

Meta-analysis shows that hospital patients benefit from reduced venous thromboembolic risks

MONDAY, July 23 (HealthDay News) -- Routine prophylactic anticoagulation in hospitalized patients can reduce venous thromboembolic risks compared to placebo, but not mortality, according to study findings published in the July 23 issue of the Archives of Internal Medicine.

Henry Krum, Ph.D., of Monash University and Alfred Hospital in Melbourne, Australia, and colleagues conducted a meta-analysis of 36 randomized controlled trials. Fourteen trials compared unfractionated heparin with a control, 11 compared low-molecular-weight heparin to a control, 10 compared the two types of heparin to each other, and one compared fondaparinux sodium with placebo.

Compared to placebo, the researchers found that both unfractionated heparin and low-molecular-weight heparin were associated with lower risks of deep vein thrombosis (67 percent and 44 percent, respectively) and pulmonary embolism (36 percent and 63 percent, respectively). They also found that low-molecular-weight heparin was associated with lower risks compared to unfractionated heparin for deep vein thrombosis (32 percent) and hematoma (53 percent). Neither therapy, however, was associated with lower death rates compared to placebo.

"We believe that routine prophylactic anticoagulation has an important place in the medical setting," the authors conclude. "Although such therapy may not necessarily decrease mortality among hospitalized medical patients, it will reduce the occurrence of deep vein thrombosis and pulmonary embolism and therefore the burden of illness currently caused by these events."

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