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A Journal on Forensic Medicine
Minerva Medicolegale 2008 June;128(2):69-84
Utility and limits of venous thromboembolism guidelines application in the retrospective study of medical behaviours. Legal-medical aspects
Zaami S., Lauricella M., Marinelli E.
Dipartimento di Medicina Legale Università degli Studi di Roma La Sapienza, Roma, Italia
Notoriously pulmonary embolism is responsible of remarkable number of deaths. Moreover, the disease’s incidence is probably underestimated because sometimes thromboembolic episodes are not diagnosed, remaining underrated even after necroscopic examination. Actually, clear scientific evidences show the usefulness and effectiveness of a suitable antithrombotic prophylaxis and a timely therapy. Therefore, guidelines were developed with the aim to accelerate and facilitate decision-making processes both in individuals at risk both in patients with thromboembolic disease in progress. While the international scientific community has come to universally shared indications for surgical patients, the opportunity to make a preventive treatment in patients with medical illness or victims of minor trauma is still contested. For these reasons, but also for other forensic questions, it is clear that the simply assessment of antithrombotic guidelines applications cannot be enough for the resolution of all medical-legal issues correlated with management of venous thromboembolic disease. Consequently it is necessary to analyse thoroughly the current indications of the international scientific community in order to consider their applicability to any possible profile of professional liability.