Risk Management of Venous Thromboembolism in Inpatients at Tertiary Hospitals in China: A Retrospective Longitudinal Study

Abstract

Abstract Background While it is recognized that racial differences in the risk of venous thromboembolism (VTE) exist between Asian and Western populations, comprehensive data on VTE risk, bleeding risk, and prevention strategies among large-scale hospitalized patients in China remain limited. Materials and Methods A retrospective longitudinal study was conducted on 85,366 adult inpatients, hospitalized for more than 24 hours at a tertiary comprehensive hospital in China from May 1, 2021 to April 30, 2022. Standardized assessment tools recommended by the 9th edition of the CHEST guidelines were used to assess the patient’s VTE and bleeding risks. An analysis was performed on their demographic characteristics, risk factors, use of prevention measures, and VTE incidence. Results The study found that among surgical and medical inpatients, the proportions of patients at high risk for VTE were 4.97% (95%CI: 4.77%-5.18%) and 11.23% (95%CI: 10.93%-11.53%), respectively. The highest proportions of high-risk patients were observed in diseases of the circulatory system (9.90%, 95%CI: 8.83%-11.08%) and certain infectious and parasitic diseases (19.31%, 95%CI: 16.36%-22.64%). Among those assessed for bleeding risk, the proportions of surgical and medical inpatients at high risk were 3.47% and 16.69% (95 CI: 15.57%-17.87%), respectively. However, the proportion of patients receiving different types of preventive measures did not reach 80% in both surgical and medical groups. The VTE incidence rates during hospitalization for surgical and medical patients were 0.65% (95%CI:0.58%-0.73%) and 2.24% (95 CI: 2.1%-2.39%), respectively, with the highest VTE rates observed in patients with diseases of the circulatory system both. The study also found significant differences in VTE risk among different diseases and between surgical and medical inpatients. Conclusion Despite most patients undergoing VTE and bleeding risk assessments, adherence to guideline-recommended prevention strategies was not optimal. This underscores the need for healthcare professionals to raise awareness and take proactive measures to reduce the disease burden and improve patient outcomes.