VTE Prophylaxis Audit – Pre-Operative Hip Fracture Patients

Patients presenting with hip fractures represent one of the highest-risk groups for venous thromboembolism (VTE), owing to immobility, advancing age, and the physiological stress of fracture. Early pharmacological VTE prophylaxis significantly reduces morbidity and mortality in this population. NICE NG89 provides clear guidance: VTE prophylaxis should be offered for one month in fragility fractures of the pelvis, hip, and proximal femur where VTE risk outweighs bleeding risk; pre-operative LMWH should be started if surgery is delayed beyond the day after admission, with the last dose ≥12 hours before surgery; fondaparinux may be used as an alternative with ≥24 hours before surgery. King's College Hospital Trust policy mandates VTE risk assessment on admission and prompt LMWH prescribing unless contraindicated, with documentation of any omission and reason. This retrospective audit reviewed 50 consecutive hip fracture patients admitted during September–October 2025 to assess compliance with NICE and local trust guidance at PRUH.