Members of the entire committee are listed in Box 1.
Prevention of venous thromboembolism in patients admitted to Australian hospitals: summary of National Health and Medical Research Council clinical practice guideline
Version of Record online: 14 JUN 2012
© 2012 National Health and Medical Research Council. Internal Medicine Journal © 2012 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 42, Issue 6, pages 698–708, June 2012
How to Cite
Wickham, N., Gallus, A. S., Walters, B. N. J., Wilson, A. and the NHMRC VTE Prevention Guideline Adaptation Committee (2012), Prevention of venous thromboembolism in patients admitted to Australian hospitals: summary of National Health and Medical Research Council clinical practice guideline. Internal Medicine Journal, 42: 698–708. doi: 10.1111/j.1445-5994.2012.02808.x
Funding: The development of the 2009 NHMRC Clinical Practice Guideline for the Prevention of Venous Thromboembolism in Patients Admitted to Australian Hospitals was funded by the NHMRC.
Conflict of interest: As with all working committees established under Section 39 of the NHMRC Act 1992, some members are eligible for remuneration by way of sitting fees and travel (arranged by NHMRC to attend meetings relating to the business of NHMRC). In this capacity the following committee members were entitled to sitting fees and travel arranged by the NHMRC to produce the guideline: N. Wickham, A.S Gallus and B.N.J. Walters. The following committee member received consultancy fees from the following organisations: A.S. Gallus – BMS/Pfizer, Bayer, Daiichi-Sankyo, Astellas, Progen and Boehringer Ingelheim.
- Issue online: 14 JUN 2012
- Version of Record online: 14 JUN 2012
- Received 22 November 2011; accepted 6 March 2012.
- venous thromboembolism;
- clincial practice guideline;
- risk assessment
Each year in Australia, about 1 in 1000 people develop a first episode of venous thromboembolism (VTE), which approximates to about 20 000 cases. More than half of these episodes occur during or soon after a hospital admission, which makes them potentially preventable. This paper summarises recommendations from the National Health and Medical Research Council's ‘Clinical Practice Guideline for the Prevention of Venous Thromboembolism in Patients Admitted to Australian Hospitals’ and describes the way these recommendations were developed. The guideline has two aims: to provide advice on VTE prevention to Australian clinicians and to support implementation of effective programmes for VTE prevention in Australian hospitals by offering evidence-based recommendations which local hospital guidelines can be based on. Methods for preventing VTE are pharmacological and/or mechanical, and they require appropriate timing, dosing and duration and also need to be accompanied by good clinical care, such as promoting mobility and hydration whilst in hospital. With some procedures or injuries, the risk of VTE is sufficiently high to require that all patients receive an effective form of prophylaxis unless this is contraindicated; in other clinical settings, the need for prophylaxis requires individual assessment. For optimal VTE prevention, all patients admitted to hospital should have early and formal assessments of: (i) their intrinsic VTE risk and the risks related to their medical conditions; (ii) the added VTE risks resulting from surgery or trauma; (iii) bleeding risks that would contraindicate pharmacological prophylaxis; (iv) any contraindications to mechanical prophylaxis, culminating in (v) a decision about prophylaxis (pharmacological and/or mechanical, or none). The most appropriate form of prophylaxis will depend on the type of surgery, medical condition and patient characteristics. Recommendations for various clinical circumstances are provided as summary tables with relevance to orthopaedic surgical procedures, other types of surgery and medical inpatients. In addition, the tables indicate the grades of supporting evidence for the recommendations (these range from Grade A which can be trusted to guide practice, to Grade D where there is more uncertainty; Good Practice Points are consensus-based expert opinions).