From the Guidelines
Deep vein thrombosis (DVT) is most likely to occur in individuals with risk factors such as prolonged immobility, recent surgery or trauma, pregnancy, use of estrogen-containing medications, cancer, older age, obesity, smoking, and personal or family history of blood clotting disorders, as supported by the most recent evidence from 1. The major risk factors for DVT include:
- Prolonged immobility, such as during long flights or bed rest
- Recent surgery or trauma, especially orthopedic procedures
- Pregnancy and the postpartum period
- Use of estrogen-containing medications, like birth control pills or hormone replacement therapy
- Cancer and cancer treatments
- Older age, especially over 60
- Obesity
- Smoking
- Personal or family history of blood clotting disorders Medical conditions that increase risk include:
- Heart failure
- Inflammatory bowel disease
- Certain inherited clotting disorders, like Factor V Leiden mutation Previous DVT or pulmonary embolism significantly increases the risk of recurrence, as noted in 1. The risk is cumulative, meaning having multiple factors substantially increases the likelihood of developing DVT. The underlying mechanism involves Virchow's triad: blood stasis (slowed blood flow), hypercoagulability (increased tendency for blood to clot), and endothelial injury (damage to blood vessel walls), as described in 1. Understanding these risk factors is important for prevention, especially in high-risk situations where prophylactic measures like compression stockings, intermittent pneumatic compression devices, or anticoagulant medications might be recommended, as suggested in 1. It is essential to consider the individual's risk factors and medical history when assessing the likelihood of DVT, as emphasized in 1.
From the FDA Drug Label
In the EINSTEIN CHOICE study, other risk factors included idiopathic VTE (43%), previous episode of DVT/PE (17%), recent surgery or trauma (12%), prolonged immobilization (10%), use of estrogen containing drugs (5%), known thrombophilic conditions (6%), Factor V Leiden gene mutation (4%), or active cancer (3%) In the EINSTEIN DVT and EINSTEIN PE studies, other risk factors included previous episode of DVT/PE (19%), recent surgery or trauma (18%), immobilization (16%), use of estrogen-containing drug (8%), known thrombophilic conditions (6%), or active cancer (5%)
The risk factors for Deep Vein Thrombosis (DVT) include:
- Idiopathic VTE: 43% in the EINSTEIN CHOICE study and 49% in the EINSTEIN DVT and EINSTEIN PE studies
- Previous episode of DVT/PE: 17% in the EINSTEIN CHOICE study and 19% in the EINSTEIN DVT and EINSTEIN PE studies
- Recent surgery or trauma: 12% in the EINSTEIN CHOICE study and 18% in the EINSTEIN DVT and EINSTEIN PE studies
- Prolonged immobilization: 10% in the EINSTEIN CHOICE study and 16% in the EINSTEIN DVT and EINSTEIN PE studies
- Use of estrogen-containing drugs: 5% in the EINSTEIN CHOICE study and 8% in the EINSTEIN DVT and EINSTEIN PE studies
- Known thrombophilic conditions: 6% in both the EINSTEIN CHOICE and EINSTEIN DVT and EINSTEIN PE studies
- Factor V Leiden gene mutation: 4% in the EINSTEIN CHOICE study
- Active cancer: 3% in both the EINSTEIN CHOICE and EINSTEIN DVT and EINSTEIN PE studies 2 2
From the Research
Risk Factors for Deep Vein Thrombosis (DVT)
The risk factors for DVT can be categorized into several groups, including:
- Immobility-related risk factors
- Surgical and hospitalization-related risk factors
- Genetic and inherited risk factors
- Cancer-related risk factors
Immobility-Related Risk Factors
Immobility is a well-recognized risk factor for DVT, particularly in patients who are bedridden or have limited mobility 3, 4. Studies have shown that immobility for more than 3 days is a significant risk factor for proximal DVT in acutely ill medical inpatients 3. Additionally, transient immobility at home, minor leg injuries, and plaster cast use have also been associated with an increased risk of thrombosis 4.
Surgical and Hospitalization-Related Risk Factors
Hospitalization, surgery, and fractures are also significant risk factors for DVT 4, 5. Patients who have recently undergone surgery or have been hospitalized are at increased risk of developing VTE, including DVT 5. The risk of thrombosis is particularly high in the first 2 weeks after hospital discharge 4.
Genetic and Inherited Risk Factors
Factor V Leiden (FVL) mutation is a common inherited defect that predisposes individuals to venous thrombosis, including DVT 6. FVL carriers are at increased risk of developing thrombosis, particularly in the presence of other risk factors.
Cancer-Related Risk Factors
Cancer is also a significant risk factor for DVT, particularly in patients with active cancer 7. Patients with VTE and active cancer are at increased risk of recurrent VTE and major bleeding, and require careful management with anticoagulant therapy 7.
Other Risk Factors
Other risk factors for DVT include age, body mass index, and family history of thrombosis 4, 6. These risk factors can contribute to the development of DVT, either alone or in combination with other risk factors.