Venous thromboembolism in acutely ill hospitalized medical patients☆

Abstract 

Background

Acute and chronic illness, immobility, and procedural and pharmacologic interventions may predispose patients in the Internal Medicine Wards to venous thromboembolic disease (VTE). The purpose of this study was to determine the incidence of VTE in these patients.

Materials and Methods

A retrospective chart review of cohort of consecutive patients admitted to Internal Medicine wards in Spain between January 1st 2005 and December 31st 2007 was performed. For each patient, demographic data, risk factors for VTE and the diagnosis of VTE during hospitalization was recorded.

Results

We analyzed 1,567,659 patients, excluding 28,226 patients who had DVT or PE before admission, and 196,555 who were discharged in the first 48 hours. We identify 12,458 new diagnosed VTE events among 1,344,959 patients (incidence 0.93%) hospitalized more than two days. Hospitalized-acquired VTE risk factors were feminine gender (odds ratio [OR] 1.31; CI95% 1.26-1.35), age >70 (OR 1.08 CI95% 1.04-1.13), acute infectious disease (OR 1.27 CI95% 1.17-1.38), acute respiratory disease (OR 1.23 CI95% 1.17-1.28), dementia (OR 1.22 CI95% 1.14-1.31), neoplasic disease (OR 2.29, CI95% 2.19-2.49), and hemiplegia (OR 1.49, CI95% 1.31-1.69).

Conclusions

The number of patients with VTE in an Internal Medicine ward is higher than expected. Several independent risk factors for VTE were identified. Based on the large number of patients who developed a VTE during hospitalization, our data add strength to the argument that VTE prevention should be high on the list of priorities when health care policies are being formed.