Thromboembolism after major trauma

To the Editor: The study by Geerts et al. (Dec. 15 issue)¹ emphasizes once again the substantial incidence of thromboembolism after major trauma. We were surprised, however, that such a prospective study was undertaken in a group of high-risk patients and that no prophylaxis against thromboembolism was used. As the authors themselves have noted, high rates of deep-vein thrombosis in patients with multiple trauma have been described previously.² The National Institutes of Health Consensus Development Conference also recognized this fact and recommended prophylaxis for such patients three years before Geerts et al. started their prospective study.³ Why was no prophylaxis.