Which Pharmacologic VTE Prophylaxis in Hospitalized Adults?

Guidelines on preventing venous thromboembolism (VTE) in hospitalized adults give similar-grade recommendations for low-molecular-weight heparin (LMWH), fondaparinux, or unfractionated heparin (UFH). However, a prior meta-analysis — which included many trials focusing on high-risk patients (e.g., those with myocardial infarction, ischemic stroke, or critical illness) — suggested that LMWH best balanced VTE reduction with major bleeding risk. For the current meta-analysis, researchers excluded studies centered on the highest-risk populations. Using data on nearly 44,000 general medicine patients from 22 randomized trials, they evaluated 90-day outcomes across three anticoagulant classes (Figure 1): UFH, LMWH/fondaparinux (fondaparinux…