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Risk Assessment, Prophylaxis, and Treatment Among Hospital-Acquired VTE in China: A Nationwide, Multicenter Cohort
Zhi-Chun Gu1, Yi-Dan Yan1, Dong Jia2
1Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Clinical Pharmacy, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background:
Venous thromboembolism (VTE) is a common preventable cause of unexpected mortality in hospitalized patients. However, in-hospital and postdischarge VTE management status in China remains unclear.
Objectives:
The authors aimed to investigate real-world VTE risk evaluation, prevention, and treatment among hospitalized VTE patients nationwide.
Methods:
We conducted a nationwide, retrospective, prospective, multicenter cohort study of Chinese venous thromboembolism in inpatients between January 2021 and September 2023 across 76 hospitals in China (registration number: ChiCTR2100047692). This study included patients with radiologically confirmed in-hospital VTE. VTE and bleeding risks were assessed within 24 hours of admission using hospital information system-embedded tools. Prophylaxis and treatment strategies followed each hospital's VTE protocols. Patients were followed up via telephone or outpatient visits at 1, 3, and 6 months postdischarge.
Results:
A total of 1,184 patients were included, with a median follow-up duration of 181 (IQR: 68-194) days. Bleeding risk increased proportionally with VTE risk, with nearly all patients at bleeding risk classified as having a moderate or higher VTE risk. Among patients with confirmed VTE diagnosis, 42.6% (504/1,184) received any form of prophylaxis (mechanical, pharmacologic, or combined prophylaxis). Low-molecular-weight heparin and graduated compression stockings were the predominant in-hospital pharmacologic and mechanical interventions, respectively. Postdischarge, direct oral anticoagulants and graduated compression stockings were the primary therapeutic options.
Conclusions:
This study demonstrates the need for improved standardization of VTE risk assessment, prophylaxis, and treatment practices in China to prevent hospital-acquired VTE and optimize patient outcomes.
