Thromboprophylaxis in the general medical patients: making sense of the current guidelines and controversial issues

There is sufficient data for thromboprophylaxis in surgical patients. If we follow these guidelines for medically ill patients it would result in giving anticoagulants to a large number of patients. The guidelines are based upon prevention of asymptomatic DVT as an endpoint. The number of such patients who develop symptomatic DVT is very small. It would be worthwhile studying the risk factors for DVT in those with symptomatic DVT. We could then target thromboprophylaxis at a selected group of acutely ill medical patients who would benefit most by this intervention.