Do prevention strategies for VTE really work?
Prevention of VTE works remarkably well. The Agency for Healthcare Research and Quality (AHRQ) has identified 11 “Clear Opportunities for Safety Improvement,” based on the strength of the evidence supporting more widespread implementation. The top-ranked item on this list is “appropriate use of prophylaxis to prevent venous thromboembolism in patients at risk.”5 Many large, dependable clinical trials have proven the benefit of primary thromboprophylaxis for prevention of VTE. Appropriately dosed chemical prophylaxis (e.g., unfractionated or low molecular-weight subcutaneous heparin) reduces DVT, PE, and (most importantly) fatal PE. In addition to improving outcomes, prophylactic measures are relatively inexpensive and cost-effective. The American College of Chest Physicians (ACCP) has published the standard evidencebased guidelines for prevention and treatment of VTE. This comprehensive document summarizes the available evidence and is an invaluable resource.2 How good are we at provid
