The lowest number of deaths occurred in patients in group B. Patients in groups A and C were more than twice as likely to have died as those in group B. There was no difference in the number of deaths between groups A and C. Patients in group A were also at 60-70% greater risk of non-fatal pulmonary embolism than those in group B, indicating that pulmonary embolism occurs despite the use of powerful anticoagulants.
Sharrock and colleagues conclude that the American College of Chest Physicians should reconsider their guidelines to reflect the fact that pulmonary embolism occurs despite the use of potent anticoagulants and may, in fact, expose patients to increased mortality after surgery. In their view, the current recommendations often result in physicians feeling compelled to prescribe these anticoagulants to avoid potential litigation when, in reality, these drugs could be doing more harm than good.
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