Data showing that treatment with low-dose unfractionated heparin reduced the rate of fatal pulmonary embolism (PE) following surgery were published over 30 years ago [1-3]. However, although the risks of venous thromboembolism (VTE) in hospitalised patients may range from 15% to 50% [4], a significant number of patients in the UK (and indeed worldwide) are still not risk-assessed for VTE and/or do not receive appropriate thromboprophylaxis [5-8]. This is despite several randomised controlled trials in both medicine and surgery with each newly emerging anticoagulant [9] and the demonstration by the US Agency for Healthcare Research and Quality that thromboprophylaxis reduces both adverse patient outcomes and overall costs [10].
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