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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
A 62-year-old man is admitted with fever, cough, and dyspnea. He is weak, appears to be dehydrated, and has purulent sputum. His temperature is 39.2°C, respirations 22, and blood pressure 128/69 mm Hg. There are crackles over the left lower lung field, and chest radiography shows a density in the left lower lobe that is consistent with pneumonia. Should thromboprophylaxis be provided?
The Clinical Problem
Strategies and Evidence
Assessment of Risk
Prophylaxis
Nonpharmacologic Therapies
Anticoagulant Prophylaxis
Comparison of Anticoagulant Regimens
Patients with Cancer
Patients with Stroke
Patients with Other Critical Illnesses
Strategies to Increase the Use of Anticoagulation in At-Risk Hospitalized Patients
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Department of Hematology and Oncology, University of Rochester Medical Center, Rochester, NY.
Address reprint requests to Dr. Francis at the University of Rochester Medical Center, 601 Elmwood Ave., Box 610, Rochester, NY 14642, or at charles_francis@urmc.rochester.edu.
Related Letters:
Prophylaxis for Thromboembolism in Hospitalized Medical Patients
Calderón-Gerstein W., Famularo G., Minisola G., De Simone C., Francis C. W.
Extract |
Full Text |
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N Engl J Med 2007;
357:304-306, Jul 19, 2007.
Correspondence
This article has been cited by other articles:
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