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DOI: 10.1055/s-2002-34077
Thromboprophylaxis in Medical Patients: Focus on France
Publication History
Publication Date:
16 September 2002 (online)
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ABSTRACT
In 2000, the French authorities licensed the low-molecular-weight heparin (LMWH) enoxaparin for thromboprophylaxis in acutely ill medical patients. However, the lack of official recommendations for this group of patients has contributed to inappropriate use of LMWH. The recent College of Internal Medicine of Paris (CIMOP) and Données Epidémiologiques chez les Patients À Risque Thromboembolique (DEPART) epidemiological studies have confirmed that LMWH is prescribed for 32% of medical inpatients and up to 44% of outpatients. However, they highlight overuse in elderly bedridden patients without acute illness and underuse in patients with severe infections or cardiopulmonary disease. Guidelines are urgently needed to encourage French physicians to target thromboprophylaxis for medical patients who are genuinely at high risk of thromboembolic disease and to prescribe the appropriate dose and duration of therapy.
KEYWORDS
Medical patients - outpatients - enoxaparin - low-molecular-weight heparin - thromboprophylaxis
REFERENCES
- 1 Samama M M, Cohen A T, Darmon J Y. A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. Prophylaxis in Medical Patients with Enoxaparin Study Group. N Engl J Med . 1999; 341 793-800
- 2 Samama M M. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch Intern Med . 2000; 160 3415-3420
- 3 Bergmann J-F, Elkharrat D. Prevention of venous thromboembolic risk in non-surgical patients. Haemostasis . 1996; 26(Suppl 2) 16-23
- 4 Geerts W H, Heit J A, Clagett P. Prevention of venous thromboembolism. Chest . 2001; 119(Suppl 1) 132S-175S
- 5 Hillbom M, Erilä T, Flosbach K. Enoxaparin, a low molecular weight heparin, is superior to heparin in the prevention of deep vein thrombosis in patients with acute atherothrombotic stroke. Thromb Haemost . 1999; (Suppl) 59-60 (Abst 177)
- 6 Flosbach C W, Koppenhagen K. Comparison of the low molecular weight heparin enoxaparin with unfractionated heparin in the prevention of venous thromboembolic events in patients with heart failure NYHA III/IV (PRINCE II study). Circulation . 1999; 100(18 Suppl 1) I-619 (Abst 3265) (Abst 177)
- 7 Fraisse F, Holzapfel L, Coulaud J-M. Nadroparin in the prevention of deep vein thrombosis in acute decompensated COPD. The Association of Non-university Affiliated Intensive Care Specialist Physicians of France. Am J Respir Crit Care Med . 2000; 161 1109-1114
- 8 Kleber F X, Witt C, Flosbach C W, Koppenhagen K, Vogel G. Comparison of the low molecular weight heparin enoxaparin with unfractionated heparin in the prevention of venous thromboembolic events in medical patients with severe cardiopulmonary disease. Thromb Haemost. 1999; 82-492 (Abst 1552)
- 9 Mismetti P, Laporte-Simitsidis S, Tardy B. Prevention of venous thromboembolism in internal medicine with unfractionated or low-molecular-weight heparins: a meta-analysis of randomised clinical trials. Thromb Haemost . 2000; 83 14-19