OBJECTIVE: The aim of this prospective study was to observe the prescription of low-molecular weight heparin (LMWH) for the prophylaxis of venous thromboembolic disease in medical patients. METHODS: We included all the patients on LMWH prophylaxis in 5 medical departments of Sainte-Marguerite Hospital in Marseille. The study described the reasons for this prophylaxis, the thrombotic risk, the follow-up quality and the side-effects. RESULTS: During four months, 189 (14.3%) of 1317 medical patients have received a prophylaxis with LMWH; sixty one per cent of them were older than 70 years. Thrombotic risk as measured with Thilly's score was low in 50 patients (26%), moderate in 81 patients (43%), high in 58 patients (31%). Platelet count follow-up was optimal in 88 patients (47%). A decrease of platelet count over 30%, reaching less than 100 G/l, was recorded in 4 patients. A venous thrombosis was diagnosed clinically in one patient. Two patients had an overt severe bleeding. A serious hidden bleeding was suspected in 11 patients. CONCLUSION: LMWH were frequently prescribed for the prophylaxis of venous thromboembolic disease in medical patients. Most of these patients were over 70 years of age. Platelet count follow-up was in accordance with guidelines in less than half of the patients. Bleedings were not rare on this treatment. The present work suggests that a precise thrombotic risk assessment is needed before the onset of this therapy and that the association with aspirin should be careful.
OBJECTIVE: The aim of this prospective study was to observe the prescription of low-molecular weight heparin (LMWH) for the prophylaxis of venous thromboembolic disease in medical patients. METHODS: We included all the patients on LMWH prophylaxis in 5 medical departments of Sainte-Marguerite Hospital in Marseille. The study described the reasons for this prophylaxis, the thrombotic risk, the follow-up quality and the side-effects. RESULTS: During four months, 189 (14.3%) of 1317 medical patients have received a prophylaxis with LMWH; sixty one per cent of them were older than 70 years. Thrombotic risk as measured with Thilly's score was low in 50 patients (26%), moderate in 81 patients (43%), high in 58 patients (31%). Platelet count follow-up was optimal in 88 patients (47%). A decrease of platelet count over 30%, reaching less than 100 G/l, was recorded in 4 patients. A venous thrombosis was diagnosed clinically in one patient. Two patients had an overt severe bleeding. A serious hidden bleeding was suspected in 11 patients. CONCLUSION:LMWH were frequently prescribed for the prophylaxis of venous thromboembolic disease in medical patients. Most of these patients were over 70 years of age. Platelet count follow-up was in accordance with guidelines in less than half of the patients. Bleedings were not rare on this treatment. The present work suggests that a precise thrombotic risk assessment is needed before the onset of this therapy and that the association with aspirin should be careful.