Immobility of patients in medical and orthopaedic departments

0049-3848/$ see front matter © 2007 Elsevier Ltd. All rights reserv doi:10.1016/j.thromres.2007.12.012 patients had been immobile within 30days before DVT diagnosis [3]. In a prospective observational study with 189 patients conducted from 2001 to 2003 in a coronary care unit pulmonary embolism was significantly associated with immobilization (RR, 5.4; 95% CI, 2.0 to 14.4) [4]. In surgical patients immobility is part of postoperative and/or posttraumatic recovery. In medical patients immobility may be more complex. The surgical situation is mirrored only if there is a severe acute illness that first confines a previously healthy patient to his or her bed and is later followed by complete recovery. More often, though, the degree of immobility in medical patients varies due to comorbidity or the chronicity of the disease. Some authors use the expression “bedridden”, but it is not clearly stated whether their patients stayed in bed for 24h a day or what level of mobility they had. Even in the three large studies on DVT prophylaxis in medical patients (Medenox, Prevent, Artemis) the publications do not give a precise definition of immobility [5–7]. In a subgroup analysis of the Medenox trial immobility is defined “as an