Risk factors for VTE

Risk factors for venous thromboembolism (VTE) (ie deep vein thrombosis [DVT] or pulmonary embolism [PE]) are related to the individual patient and, if applicable, to a surgical procedure or a predisposing medical illness. Factors that increase VTE risk in nonsurgical patients in hospital are listed in Risk factors for VTE in nonsurgical patients in hospital. However, this is not an exhaustive list; assess each patient’s risk individually.

Figure 1. Risk factors for VTE in nonsurgical patients in hospital. [NB1]

advanced age (60 years or older)

obesity (BMI 30 kg/m2 or more)

recent trauma or surgery (within 1 month)

prior VTE

known thrombophilia (including inherited disorders)

active cancer [NB2]

myeloproliferative neoplasms

acute myocardial infarction or ischaemic stroke

heart failure

active or chronic lung disease

active infection

active rheumatological disorder

acute inflammatory bowel disease

ongoing hormonal treatment (eg estrogen-containing therapy)

nephrotic syndrome

dehydration

varicose veins or chronic venous stasis

anticipated reduced mobility (eg 50% of the day in bed)

pregnancy or less than 6 weeks postpartum

sickle cell disease

Note:

BMI = body mass index; VTE = venous thromboembolism

NB1: This is not an exhaustive list; assess each patient’s risk individually.

NB2: Active cancer is defined as patients receiving cancer treatment, those diagnosed with cancer in the past 6 months, or with progressive or advanced disease.

Assess the need for VTE prophylaxis in patients admitted to hospital; the harm–benefit balance for risk of bleeding and of thrombosis must be weighed up individually. Aim to avoid dehydration and start mobilising patients as soon as possible.

The relative risks of bleeding or VTE can change during a patient’s admission to hospital because of the evolution of their disease, and the interventions that may be carried out. To ensure optimal VTE prophylaxis, reassess patients:

  • within 24 hours of admission
  • whenever their condition changes
  • at least every 7 days
  • at any transition of care.

The Australian Commission on Safety and Quality in Health Care (ACSQHC) provides further information on patient assessment, reassessment and other aspects of VTE prevention in the VTE Prevention Clinical Care Standard.