Venous Thromboembolism Prophylaxis

Multiple national guidelines recommend restricting thromboprophylaxis to high-risk patients only, while the National Quality Forum supports universal risk assessment rather than universal treatment. The Joint Commission requires all medical inpatients to either receive prophylaxis or have a documented contraindication, but being low-risk is not formally penalized as a reason to withhold it. Heparin-based prophylaxis reduces VTE incidence but carries real risks including major bleeding and heparin-induced thrombocytopenia. VTE is a leading cause of preventable morbidity among hospitalized patients.