Venous thromboembolism in medical inpatients: Prophylaxis with low-weight heparin in a university hospital and prevalence of thromboembolic events

The aim of this study was to determine the prevalence of venous thromboembo lism (VT) in current prophylactic practice with low-molecular-weight hepari n (LMWH) among medical inpatients and to analyze associated risk factors fo r VT. A cross-sectional survey on five given days was conducted in the medical de partments of a university hospital. The prevalence of prophylaxis and confi rmed VT was measured. Risk markers for receiving high doses of LMWH and for VT under prophylaxis were assessed by logistic regression models. Of 1194 inpatients, 1.4% suffered VT. The mean proportion of patients with LMWH prophylaxis was 24% (range: 4-64%). The prevalence of VT was higher am ong inpatients receiving prophylaxis than among those patients not receivin g prophylaxis (3.5% vs. 0.7%, p = 0.002). Under prophylaxis, independent ri sk markers for thrombosis were history of vein thrombosis (odds ratio [OR]: 4.03; confidence interval [95%CI]: 1.04-15.62) and age (OR: 1.08; 95%oCI:1 .01-1.15). Two factors were independently associated with the prescription of high doses of LMWH: obesity was positively associated (OR: 7.50; 95%CI: 2.97-18.92; p < 0.0001) and respiratory insufficiency was negatively associ ated. In medical departments, current prophylaxis practice leads to many patients being given LMWH. LMWH doses and other preventive measures should be adapt ed in high-risk inpatients.