Pharmacological versus Combined Thromboprophylaxis on Mobility-Impaired Inpatients

Abstract

Deep vein thrombosis (DVT) continues to be a common yet largely preventable cause of mortality among hospitalized patients, especially in those with impaired mobility. DVT is a medical complication in which a thrombus or blood clot forms in a vein, creating a blockage. Patients with limited or no mobility—often due to an injury or surgery—are at increased risk of developing a DVT. Potential complications of a DVT include the risk for pulmonary embolism, a life-threatening condition in which a blood clot travels to the lungs and occludes blood oxygenation. DVTs also cause pain, swelling, delayed healing, or post-thrombotic syndrome. Given these risks, ensuring effective venous thromboembolism (VTE) prevention in all forms of mobility impairment is essential to prevent these complications and ensure high-quality patient care. While pharmacological prophylaxis, such as low-molecular-weight heparin, is a standard risk-reduction treatment, mechanical interventions such as sequential compression devices (SCDs) can aid in venous return and decrease venous stasis, the pooling of blood in the legs due to insufficient movement of blood through the veins. This evidence-based practice review examines whether the addition of sequential compression devices to the standard pharmacological prophylaxis reduces the incidence of VTE compared to pharmacologic prophylaxis alone. Evidence suggests that further research is necessary to draw conclusions on the comparative efficacy of combined prophylaxis and pharmacoprophylaxis alone. Findings from this review aim to assist nursing and healthcare practices in developing preventative interventions.