Use of heparin for the prevention of venous thromboembolism

The value of heparin in the prevention of venous thromboembolism has been shown effective and safe by controlled studies. However, how these studies have influenced physicians' decisions in thrombo‐prophylaxis is not known. With the aim of evaluating the frequency and the appropriateness of prophylaxis for venous thromboembolism in our centre, we performed a cross‐sectional study on a specific day. Among 667 patients who were admitted to hospital on this day, 134 (20 per cent) were receiving heparin. This had been prescribed for the prophylaxis of venous thromboembolism to 82 (12 per cent) patients. Immobilization was the risk factor most strongly associated with prophylaxis. Prophylaxis with heparin was only used in 79 out of 444 high‐risk patients (21.6 per cent). One hundred and eighty‐three patients had been subject to major surgery and heparin was being given only to 34 of them (18.6 per cent). A wide variability in the use of prophylaxis, depending on the hospital ward, was also recorded. We conclude that prophylaxis with heparin is underused in our milieu.