From the Guidelines
Venous Thromboembolism (VTE) risk factors include a combination of acquired and inherited conditions, with major risk factors being prolonged immobility, recent trauma or surgery, active cancer and cancer treatments, pregnancy and the postpartum period, use of estrogen-containing medications, and advanced age, as supported by 1.
Key Risk Factors
- Prolonged immobility, such as during long hospital stays, after surgery, or during long flights
- Recent trauma or surgery, particularly orthopedic procedures
- Active cancer and cancer treatments
- Pregnancy and the postpartum period
- Use of estrogen-containing medications like oral contraceptives or hormone replacement therapy
- Advanced age
- Obesity, smoking, and personal or family history of VTE
Medical Conditions Contributing to VTE Risk
- Heart failure
- Inflammatory disorders
- Nephrotic syndrome
- Myeloproliferative disorders
Inherited Thrombophilias
- Factor V Leiden mutation
- Protein C or S deficiency
- Antithrombin deficiency
Importance of Understanding Risk Factors
Understanding these risk factors is crucial for implementing appropriate preventive measures, including early mobilization after surgery, mechanical prophylaxis with compression devices, and pharmacological prophylaxis with anticoagulants like low molecular weight heparin or direct oral anticoagulants in high-risk situations, as emphasized by 1.
Cumulative Effect of Risk Factors
The risk of VTE increases substantially when multiple risk factors are present simultaneously, as they have a cumulative effect, highlighting the need for a comprehensive assessment of individual risk factors to guide prophylactic strategies, as noted in 1.
From the Research
Venous Thromboembolism (VTE) Risk Factors
The risk factors for Venous Thromboembolism (VTE) can be categorized into acquired and genetic factors.
- Acquired risk factors include:
- Age over 40 years 2
- Bed rest 2
- Surgery 2, 3, 4, 5
- Trauma 2, 4
- Cancer 2, 6, 4, 5
- Myocardial infarction 2
- Ischemic stroke 2
- Use of oral contraceptives 2, 6
- Hormone-replacement therapy 2, 6
- Pregnancy and puerperium 2, 6, 4
- Previous VTE 2, 4
- Long lasting travel 2
- Presence of antiphospholipid antibodies 2
- Male sex 6
- Diabetes 6
- Obesity 6, 4
- Smoking 6
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection 6
- Immobilization 6, 4
- Antiphospholipid syndrome 6
- Genetic risk factors include:
Risk Factor Assessment and Prophylaxis
Risk factor assessment is crucial in identifying patients at risk of developing VTE, and implementing appropriate thromboprophylaxis can reduce the incidence of VTE 3, 5.
- Clinical trials have demonstrated the effectiveness of thromboprophylaxis, both non-pharmacological and pharmacological, in various medical settings 3.
- The implementation of decision-making tools based on risk factor assessment can improve the prescription of appropriate VTE prophylaxis 3.
- Pharmacological thromboprophylaxis is generally warranted in patients undergoing major orthopaedic or cancer surgery 5.