Does Venous Thromboembolism Prophylaxis Lower 30-Day Mortality in Medical Inpatients?

Despite widespread use of low-molecular-weight heparin to prevent venous thromboembolism (VTE) in medical inpatients, the effect of this practice on mortality is unclear. In a trial conducted mainly in China and India, 8300 acutely ill medical inpatients were given graduated compression stockings and, additionally, were randomized to receive daily enoxaparin (40 mg) or placebo during hospitalization (6–14 days). Patients were eligible for enrollment if they had decompensated congestive heart failure; active cancer; or severe systemic infection plus chronic lung disease, obesity, previous VTE, or advanced age (>60).

All-cause mortality at 30 days, the primary outcome, was identical in the two groups — about 5%. All other efficacy endpoints (e…