Authors' objectives: To assess the available evidence on the efficacy, safety and coverage policy related aspects about the use of LMWH vs. NFH for the prevention of VET, DVT, PE in patients immobilized at home health care due to conditions such as cancer, orthopedic surgeries or advanced age.

Authors' recommendations: No evidence was found on the subcutaneous use of NFH in preventing DVT-PE in immobilized patients in home care, after an orthopedic surgery, cancer or elderly. New studies will be necessary to determine its use in this population. About the use of LMWH in preventing DVT-PE after orthopedic surgery, cancer or in the elderly, the studies found presented an adequate level of evidence which shows that LMWHs are as efficacious as intravenous NFH, they have a simpler follow up and administration but they have a slight increase in the incidence of bleeding and they are more expensive. The indication of LMWH is at the same level as the other anticoagulation agents in hip or knee replacement, being the alternative of choice in facture of the hip. In case of high risk of bleeding after a major orthopedic surgery, mechanical prophylaxis is recommended. In both cancer and elderly patients, unless there are no added risk factors, the use of anticoagulation prophylaxis is not recommended.

Project Status: Completed

Year Published: 2012

URL for published report: https://www.iecs.org.ar/home-ets/?cod_publicacion=1490&origen_publicacion=publicaciones

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)