Extended thromboprophylaxis: Defining the case, refining the approach

Venous thromboembolism (VTE), consisting of deep-vein thrombosis (DVT) and pulmonary embolism (PE), is the third leading cause of cardiovascular death after myocardial infarction and stroke. There is an increased risk of VTE after orthopedic surgery, particularly total hip replacement (THR) and total knee replacement (TKR) where, without thromboprophylaxis, the incidence of postoperative DVT is approximately 4060%. Hospitalized medical patients are also at risk for developing VTE. Of those who do not receive appropriate thromboprophylaxis, from 5% to 15% develop objectively confirmed deep-vein thrombosis. Up to 75% of PE occurs in hospitalized medical patients. © 2010 John Wiley Sons A/S.