urche, You are probably right about this in the sense it is easier for the physician, but the patient would (given the choice)I think prefer an oral agent such as low dose ASA (certainly of questionable value in DVT prophylaxis so not really part of this argument)or a few weeks of coumadin even with frequent blood tests, over a daily injection that leaves a lovely and perhaps painful abdominal ecchymosis and may not be easily (read comfortably) administered at home by patient or family. Not that its a bad idea. Are you aware (I am not) of any studies that promote continued low dose lovonox prophylaxis once this selected group of frail recovering patients becomes ambulatory? Your points about coumadin of course are well taken, its is hard to adjust especially in the frail and elderly and carries its own risks including drug drug interactions as you point out and there is no "low dose" eg INR<2.0 option of therapeutic value, unlike low dose lovonox. bp
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