Dalteparin vs Unfractionated Heparin For The Prevention Of Venous Thromboembolism (VTE) In Hospitalized Acutely Ill Medical Patients

• Drug: Dalteparin (Fragmin)
  
  Dalteparin 5000 IU once daily subcutaneously for 6-14 days.
• Drug: Unfractionated heparin
  
  Unfractionated heparin 5000 IU thrice daily subcutaneously for 6-14 days.

• Active Comparator: B
  
  Intervention: Drug: Unfractionated heparin
• Experimental: A
  
  Intervention: Drug: Dalteparin (Fragmin)

Inclusion Criteria:

• Aged greater than or equal to 18 years
• Acute medical condition with a projected hospitalization of greater than or equal to 4 days and had less than or equal to 3 days of prior immobilization for more than two thirds of the day
• Acute congestive heart failure Class III-IV per NHYA/ Acute respiratory failure not requiring mechanical ventilation or Both
• Acute infection without septic shock/ Acute episode of inflammatory bowel disease/ Acute rheumatologic disorders/ Acute lumbar pain or sciatica or vertebral compression with at least one risk factor for VTE

Exclusion Criteria:

• Contraindications to use of anticoagulants
• Active bleeding or abnormal coagulation tests
• Recent (less than 1 month) head injury, hemorrhagic stroke, cerebral tumor or intracranial aneurysm or ischemic stroke within the last month.
• Major surgical or invasive procedure within the last month resulting in ongoing convalescence
• Lumbar or spinal puncture within last 48 hours
• S creatinine levels more than 2
• On inotropic agents