Deep vein thrombosis prophylaxis: friend or foe.

This article reviews certain aspects of venous thromboembolism, a major cause of morbidity and mortality among hospitalized patients. Deep vein thrombosis is a frequent complication of various surgical procedures. Knowing predisposing factors, including hereditary causes, and triggering risk factors will help us identify patients with high risk of venous thromboembolism. The prophylaxis recommendations by American College of Chest Physicians are made for groups of patients, for whom the benefits seem to outweigh the risks. However, those readers who want to adopt the American College of Chest Physicians' guidelines in their practices are urged to review in detail the pharmacology of the drugs used for thromboprophylaxis, relevant clinical studies, and case reports of spinal hematoma. Each patient might have different risks for thrombosis or bleeding and the potential for adverse consequences due to the prophylaxis. What is best for the group (the epidemiologic perspective) is not necessarily what is best for the individual patient (the clinical perspective).