2008
DOI: 10.1007/s00068-008-8015-y
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Insufficient Evidence for Routine Use of Thromboprophylaxis in Ambulatory Patients with an Isolated Lower Leg Injury Requiring Immobilization: Results of a Meta-Analysis

Abstract: There is insufficient evidence to warrant routine use of thromboprophylaxis in ambulatory patients with below-knee or lower leg immobilization after an isolated lower leg injury. The incidence of symptomatic VTE is too low to show a relevant clinical benefit from thromboprophylaxis.

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Cited by 8 publications
(5 citation statements)
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“…The section of the NHMRC guideline pertaining to immobilization for leg injury was based on a systematic review by Testroote et al, 12 which was at odds with the recommendations of two other similar reviews. 6,20 The Testroote et al review combined six randomized controlled trials of which three reported no statistically significant reduction in VTE from LMWH use. [21][22][23] VTE incidence varied widely between studies, being highest in patients having surgery for ATR (34%) 21 and lowest in patients being discharged from the ED (4%).…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The section of the NHMRC guideline pertaining to immobilization for leg injury was based on a systematic review by Testroote et al, 12 which was at odds with the recommendations of two other similar reviews. 6,20 The Testroote et al review combined six randomized controlled trials of which three reported no statistically significant reduction in VTE from LMWH use. [21][22][23] VTE incidence varied widely between studies, being highest in patients having surgery for ATR (34%) 21 and lowest in patients being discharged from the ED (4%).…”
Section: Discussionmentioning
confidence: 99%
“…ED LOS was included as one of the study variables for this reason, and increased LOS was not found to be significantly associated with VTE. The section of the NHMRC guideline pertaining to immobilization for leg injury was based on a systematic review by Testroote et al ., 12 which was at odds with the recommendations of two other similar reviews 6,20 . The Testroote et al .…”
Section: Discussionmentioning
confidence: 99%
“…84 - 86 Some researchers support that the incidence of symptomatic VTE is equivocal to THR, while others report no sufficient evidence to warrant routine use of VTE prophylaxis in these patients. 87 , 88 According to Metz et al, 82 there is no sufficient evidence to warrant routine use of VTE prophylaxis in ambulatory patients with below-knee or lower-leg immobilization after an isolated lower-leg injury, because there is a too-low incidence of symptomatic VTE that is not able to show a relevant clinical benefit from VTE prophylaxis. Current ACCP guidelines suggest no VTE prophylaxis rather than pharmacologic VTE prophylaxis in patients with isolated lower-leg injuries requiring leg immobilization (Grade 2C).…”
Section: Guidelinesmentioning
confidence: 99%
“…With foot and ankle surgery, there is no consensus; some studies do not recommend prophylaxis in outpatient surgery patients without individual risks for VTE or those not requiring immobilization [293][294][295][296][297] . Furthermore, others advise using VTE prophylaxis in long cast immobilization, independent of the previous procedure, until weightbearing or removal [298][299][300] .…”
Section: -Is Routine Vte Prophylaxis Indicated In Patients With Immob...mentioning
confidence: 99%