PT - JOURNAL ARTICLE AU - Daniel Horner AU - Steve Goodacre AU - Abdullah Pandor AU - Timothy Nokes AU - Jonathan Keenan AU - Beverley Hunt AU - Sarah Davis AU - John W Stevens AU - Kerstin Hogg TI - Thromboprophylaxis in lower limb immobilisation after injury (TiLLI) AID - 10.1136/emermed-2019-208944 DP - 2019 Nov 06 TA - Emergency Medicine Journal PG - emermed-2019-208944 4099 - http://emj.bmj.com/content/early/2019/11/06/emermed-2019-208944.short 4100 - http://emj.bmj.com/content/early/2019/11/06/emermed-2019-208944.full AB - Venous thromboembolic disease is a major global cause of morbidity and mortality. An estimated 10 million episodes are diagnosed yearly; over half of these episodes are provoked by hospital admission/procedures and result in significant loss of disability adjusted life years. Temporary lower limb immobilisation after injury is a significant contributor to the overall burden of venous thromboembolism (VTE). Existing evidence suggests that pharmacological prophylaxis could reduce overall VTE event rates in these patients, but the proportional reduction of symptomatic events remains unclear. Recent studies have used different pharmacological agents, dosing regimens and outcome measures. Consequently, there is wide variation in thromboprophylaxis strategies, and international guidelines continue to offer conflicting advice for clinicians. In this review, we provide a summary of recent evidence assessing both the clinical and cost effectiveness of thromboprophylaxis in patients with temporary immobilisation after injury. We also examine the evidence supporting stratified thromboprophylaxis and the validity of widely used risk assessment methods.