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Risk factors for venous thromboembolism among psychiatric inpatients: a case control study
Takuto Ishida1, Megumi Shimada2, Masafumi Mizuno3
1Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Journal of Psychiatric Research
|August 3, 2025
Summary
Psychiatric inpatients face a higher risk of venous thromboembolism (VTE). Retarded catatonia and physical restraint significantly increase VTE risk in this population, unlike in general medical patients.
Area of Science:
- Psychiatry
- Internal Medicine
- Clinical Pharmacology
Background:
- Psychiatric inpatients exhibit an elevated risk for venous thromboembolism (VTE).
- Existing research on VTE risk factors in psychiatric inpatients primarily focuses on baseline factors, with limited data on in-hospital triggers.
- This study addresses the scarcity of information regarding in-hospital risk factors for VTE in psychiatric inpatients.
Purpose of the Study:
- To identify specific in-hospital risk factors contributing to the incidence of VTE among psychiatric inpatients.
- To differentiate VTE risk profiles in psychiatric versus general medical inpatients.
Main Methods:
- A retrospective, single-center case-control study was conducted at Tokyo Metropolitan Matsuzawa Hospital.
- Data were extracted from electronic medical records for patients diagnosed with VTE during hospitalization (cases) and matched controls.
- Multiple logistic regression analysis was employed to assess the impact of in-hospital factors like catatonia, physical restraint, seclusion, and psychotropic use on VTE risk.
Main Results:
- A total of 11,819 patients were hospitalized, with 108 (0.9%) diagnosed with VTE (pulmonary embolism or deep vein thrombosis).
- Retarded catatonia (OR: 10.1) and physical restraint (OR: 6.7) were significantly associated with increased VTE risk.
- Anticoagulant use demonstrated a protective effect, reducing VTE risk (OR: 0.3).
Conclusions:
- The identified in-hospital risk factors for VTE in psychiatric inpatients differ substantially from those observed in medical inpatients.
- Further investigation is crucial to pinpoint suitable candidates for anticoagulant prophylaxis in psychiatric care settings.
- These findings highlight the need for tailored VTE prevention strategies in psychiatric facilities.
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