Internal and Emergency Medicine

, Volume 8, Issue 6, pp 509–520 | Cite as

Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

  • Maura Marcucci
  • Alfonso Iorio
  • Alessandro Nobili
  • Mauro Tettamanti
  • Luca Pasina
  • Codjo Djignefa Djade
  • Alessandra Marengoni
  • Francesco Salerno
  • Salvatore Corrao
  • Pier Mannuccio MannucciEmail author
  • REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Investigators


Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in hospital and during the 3-month post-discharge follow-up were explored by logistic regression and propensity score analysis. Among the 1,380 patients enrolled, 171 (15.2 %) were on TP during the hospital stay (162 on low molecular weight heparins, 9 on fondaparinux). The disability Barthel index was the main independent predictor of TP prescription. Rate of fatal and non-fatal VTE and bleeding during and after hospitalization did not differ between TP and non-TP patients. In-hospital and post-discharge mortality was significantly higher in patients on TP, that however was not an independent predictor of mortality. Among elderly medical patients there was a relatively low rate of TP, that was more frequently prescribed to patients with a higher degree of disability and who had an overall higher mortality.


Thromboprophylaxis Venous thromboembolism Medical patients 


Conflict of interest



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Copyright information

© SIMI 2013

Authors and Affiliations

  • Maura Marcucci
    • 1
    • 2
  • Alfonso Iorio
    • 1
    • 2
  • Alessandro Nobili
    • 3
  • Mauro Tettamanti
    • 3
  • Luca Pasina
    • 3
  • Codjo Djignefa Djade
    • 3
  • Alessandra Marengoni
    • 4
  • Francesco Salerno
    • 5
  • Salvatore Corrao
    • 6
  • Pier Mannuccio Mannucci
    • 7
    Email author
  • REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Investigators
  1. 1.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
  2. 2.Department of MedicineMcMaster University HamiltonONCanada
  3. 3.Mario Negri Institute for Pharmacological ResearchMilanItaly
  4. 4.Geriatric Unit, Ospedali Civili, Department of Medical and Surgery SciencesUniversity of BresciaBresciaItaly
  5. 5.Internal Medicine, IRCCS Policlinico San Donato, Department of Medical and SurgeryUniversity of MilanMilanItaly
  6. 6.Biomedical Department of Internal MedicineUniversity of PalermoPalermoItaly
  7. 7.Scientific Direction, IRCCS Ca’ Granda Maggiore Hospital FoundationMilanItaly

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