入院患者における静脈血栓塞栓症予防の現状動向

Thromboprophylaxis in hospitalized patients is a critical component of care aimed at preventing venous thromboembolism (VTE), a common and potentially fatal complication during hospitalization. The risk of VTE varies substantially across patient populations, influenced by the type of illness, including both surgical procedures and medical comorbidities, and requires individualized assessment. At the same time, the implementation of pharmacological thromboprophylaxis must carefully balance the risk of thrombosis against the potential for bleeding. Commonly used risk assessment models, such as the Padua and IMPROVE scores, can help clinicians stratify patients according to their individual risk of VTE and bleeding complications. The aim of the present review is to provide a structured synthesis of the current evidence on thromboprophylaxis strategies in hospitalized patients, critically appraise the performance and applicability of existing VTE and bleeding risk models and highlight how these tools can guide a tailored illness-specific approach to prophylactic decision-making. Where relevant, the review also outlines practical, risk-adapted algorithms to optimize thromboprophylaxis across diverse clinical settings.