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Bed Rest, Deep-Vein Thrombosis, and Pulmonary Embolism

Adolf Singer, MD, FRCS
JAMA. 1983;250(23):3162. doi:10.1001/jama.1983.03340230020012.
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To the Editor.—  In the excellent review, "Pulmonary Thromboembolism: Diagnosis and Treatment," in the June 3, 1983, issue of The Journal,1 the authors make one comment that does not seem logical and that is not supported by any patient data.In the discussion of the initial heparin treatment, reference is made to "therapy for the seven to ten days or so that the patient is confined to bed." I have been involved in the treatment of many patients with deep-vein thrombosis (DVT) and pulmonary embolism (PE) during the past 20 years and have never found any evidence that either of these conditions is benefited by bed rest. There is no study that suggests that bed rest helps, and, indeed, as the authors mention, bed rest is one of the factors predisposed to DVT and PE. I well understand the fear that muscular exertion might lead to detachment of a


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