The American College of Physicians (ACP) has listed criteria for use of venous thromboprophylaxis for hospitalized medical patients. Venous thromboembolism (VTE) often goes unrecognized and can have serious complications for an affected patient.
Patient selection: hospitalized medical patient
Parameters:
(1) contraindications to heparin
(2) congestive heart failure (CHF)
(3) severe respiratory disease
(4) bedridden status
(5) risk factors for VTE
Risk factors for VTE include:
(1) active cancer
(2) history of previous venous thromboembolism
(3) sepsis
(4) acute neurologic disease
(5) other
Parameter
Finding
Points
congestive heart failure (CHF)
no
0
yes
1
respiratory disease
none to moderate
0
severe
1
status and number of risk factors
not bedridden
0
bedridden and 0 risk factors
0
bedridden and >= 1 risk factor(s)
1
number of indications to institute thromboprophylaxis =
= SUM(points for the listed parameters)
Interpretation:
• minimum number of indications: 0
• maximum number of indications: 3
Status
Thromboprophylaxis
no contraindications to heparin
low-dose unfractionated heparin OR low-molecular-weight heparin
contraindications to heparin
graduated compressing stockings OR intermittent pneumatic compression
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