Venous thromboembolism prophylaxis of acutely ill hospitalized medical patients. Are we over-treating our patients?

Venous thromboembolism (VTE) is prevalent and is associated with dire consequences. Many VTE events are related to medical hospitalization, and some of these events are avoidable when appropriate measures are taken. Despite the current knowledge of the prevalence and burden of this disease, many internists are reluctant to prescribe pharmacological prophylaxis to “at-risk” medical inpatients. The purpose of this review is to analyze the reasons for deferring such treatment, in view of the facts as presented in the medical literature. We believe that while the literature supports further emphasis on education and support systems, Internists are deficient of validated tools to decide upon their patient's true risk of clinically overt disease.