Bedridden Thromboprophylaxis: Risk Factors
Information on VTE1
- VTE is a collective term for deep vein thrombosis (DVT) and pulmonary embolism (PE).
- VTE is a significant cause of mortality, long-term disability and chronic ill-health problems, many of which are avoidable.
- The incidence of VTE is 1–2 per 1,000 of the population and the risk increases with age.
- Approximately half of VTE cases are associated with prior hospitalisation for medical illness or surgery.
- It has been estimated that the management of hospital associated VTE costs the NHS £millions per year.
VTE prevention is an important patient safety issue1
1 in 20 people will have a VTE at some time in their life and approximately half of the cases are associated with prior hospitalisation for medical illness or surgery
VTE causes a larger number of deaths than the combined mortality due to:2
- Breast cancer
- Road traffic accidents
VTE is the most common preventable cause of in-hospital death3
General risk factors4**
The general risk factors associated with the development of venous thromboembolism (VTE):
- Active cancer or cancer treatment
- Age >60 years
- Critical care admission
- Known thrombophilias
- Obesity (body mass index [BMI] >30 kg/m2)
- One or more significant medical comorbidities (e.g. heart disease; metabolic, endocrine or respiratory pathologies; acute infectious diseases; inflammatory conditions)
- Personal history or first-degree relative with a history of VTE
- Use of hormone replacement therapy (HRT)
- Use of oestrogen-containing contraceptive therapy
- Varicose veins with phlebitis
**For women who are pregnant or have given birth within the previous 6 weeks, please see section 1.16 of NICE NG89.
- NHS England. Commissioning Services that deliver High Quality VTE Prevention. Guidance for Commissioners. Available at: https://www.england.nhs.uk/wp-content/uploads/2013/08/vte-prev-guide-may2013-22.7.13.pdf
- Dolan G. J R Coll Physicians Edinb 2008;38:338–340.
- Cohen AT et al. Lancet 2008;371:387–394.
- NICE guideline 89. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. March 2018. Available at: https://www.nice.org.uk/guidance/ng89
*Including, but not limited to: congestive cardiac failure (NYHA class III or IV), acute respiratory failure or acute infection, who also have a predisposing risk factor for VTE such as age over 75 years, obesity, cancer or previous history of VTE.~
†In patients with chronic renal insufficiency or acute renal failure.
PP-FRA-GBR-0152. June 2019