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Review: low molecular weight heparin reduces risk of venous thromboembolism in adults with leg immobilisation

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QUESTION

In adults with leg immobilisation, does low molecular weight heparin (LMWH) prevent venous thromboembolism (VTE)?

REVIEW SCOPE

Included studies compared LMWH with placebo or no thromboprophylaxis in adults with a leg injury requiring immobilisation in a plaster cast or brace in an ambulatory setting. Outcomes were symptomatic or asymptomatic VTE (deep venous thrombosis [DVT] or pulmonary embolism) and bleeding events.

REVIEW METHODS

Cochrane Peripheral Vascular Diseases Group Specialised Register, PubMed, and EMBASE/Excerpta Medica (May 2008); Cochrane Central Register of Controlled Trials (Issue 2, 2008); and reference lists were searched for randomised controlled trials (RCTs) and controlled clinical trials. Pharmaceutical companies were consulted. 6 RCTs (n = 1490, mean age 34–49 y, 46–79% men) met the selection criteria. DVT was diagnosed by venography or by compression ultrasonography and/or duplex scanning confirmed …

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