Antithrombotic prophylaxis had little effect on overall mortality

BMJ 1995;311:572 (26 August)

Letters

Antithrombotic prophylaxis had little effect on overall mortality

EDITOR,--C J Todd and colleagues report that antithromboticprophylaxis significantly reduces the incidence of fatal pulmonaryembolism.¹ From their remarks in their results section, I assumethat their diagnoses of fatal pulmonary embolism were made atpostmortem examination. It would be interesting to know whatthe rate of postmortem examination at each hospital was forthis review as this would have a bearing on the number of deathsdue to pulmonary embolism.

With regard to their figures for mortality, it is also importantto look at other causes of death, such as bleeding and complicationsarising from wound sepsis.² How many deaths were due to theseproblems? In figure 1 they indicate that hospitals 3, 5, 7,and 8 were low users of antithrombotic prophylaxis. The 90 daysurvival curves indicate, however, that there was little differencein overall mortality between the hospitals other than hospital6 (if there was . . . [Full text of this article]

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Differences in mortality after fracture of hip: the East Anglian audit: C J Todd, C J Freeman, C Camilleri-Ferrante, C R Palmer, A Hyder, C E Laxton, M J Parker, B V Payne, and N Rushton
BMJ 1995 310: 904-908. [Abstract] [Full Text]