Abstract
Deep vein thrombosis and pulmonary embolism are associated with considerable morbidity
and mortality in hospitalized patients, accounting for up to 10% of hospitalization-related
deaths in both surgical and medical patients. Pharmacologic thromboprophylaxis has
been demonstrated to be effective, safe, and cost-effective in preventing hospital-acquired
venous thromboembolism (VTE) among medical inpatients, and clinician awareness of
thrombotic risk promotes prescription of thromboprophylaxis. Guidelines recommend
stratification of thrombotic risk for all patients and, unless contraindicated, administration
of VTE prophylaxis. Based on several recognized predisposing and exposing risk factors
for VTE, several scoring systems have been published in the past 15 years. Borrowing
models developed in the surgical setting, recognized risk factors for VTE complications
in medical inpatients have been combined in different weighted scores and derived
and validated in heterogeneous medical populations. Although the perfect score, balancing
thrombotic and hemorrhagic risk, has probably not yet been built, the adoption of
an easy-to-use risk assessment model has the potential to support physicians in properly
stratifying VTE risk in medical inpatients, tailoring thromboprophylaxis prescription.
Keywords
medical inpatients - venous thromboembolism - thromboprophylaxis - risk assessment
model - scoring systems
