Incidence and Characteristics of Hospital-acquired Venous Thromboembolism: A Single-Center Retrospective Study

Abstract

<p>Objectives:</p><p>Hospital-acquired venous thromboembolism (HA-VTE), a potentially fatal complication of medical care, is preventable through risk assessment and appropriate thromboprophylaxis. This study aimed to determine the incidence and characteristics of HA- VTE in Chinese medical hospitalizations.</p><p>Methods:</p><p>A retrospective analysis of patients diagnosed as HA-VTE at a single center from January 2016 to December 2022 was performed. HA-VTE was defined as deep vein thrombosis (DVT) or pulmonary embolism (PE) that happened during hospitalization. Patients with venous thromboembolism (VTE) prior to admission or within 48 hours after admission were excluded. The demographic data of patients was retrieved from the electronical medical database. The parameters affecting the occurrence of HA-VTE were analyzed.</p><p>Results:</p><p>During the study period, 4022 patients from 321,997 medical hospitalizations were diagnosed as VTE. Among these patients, 952 (23.7%) were identified as HA-VTE, corresponding to an incidence of 2.96 (95% CI; 2.78-3.15 per 1000). Among the 952 patients with HA-VTE, 76% of patients presented with DVT alone, 13% presented with isolated PE, and 11% presented with concomitant DVT and PE. The incidence of HA-VTE was significantly higher in patients with elderly age (67.5 ± 15.5 vs 48.3 ± 17.2 years; <em>P</em> < .001), male gender (3.46‰ vs 2.62‰; <em>P</em> < .001), emergency admission (6.64‰ vs 1.86‰; <em>P</em> < .001), malignancy (5.13‰ vs 2.52‰; <em>P</em> < .001), trauma (6.95‰ vs 2.80‰; <em>P</em> < .001), ICU stay (29.81‰ vs 2.26‰; <em>P</em> < .001), and patients undergoing major surgery (7.02‰ vs 1.76‰; <em>P</em> < .001). Patients with HA-VTE had longer hospital stay (22.5 ± 26.6 vs 7.21 ± 9.23 days; <em>P</em> < .001) and higher mortality rate (8.51% vs 1.01%; <em>P</em> < .001) (Table 1). Fifty-two percent (495/952) of HA-VTE events occurred in patients aged between 66 to 85 years old. The crude incidence rate of HA-VTE increased annually from 0.75 per 1000 patients in 2016 to 5.89 per 1000 patients in 2022 (Fig 1). The subspecialties with the highest incidence of HA-VTE were cardiovascular surgery (1.40%), neurosurgery (1.10%), and respiratory medicine (0.72%).</p><p>Conclusions:</p><p>Our study suggested that HA-VTE, accounting for 23.7% of all VTE events, occurred in 0.24% of adult hospitalizations. Patients diagnosed with HA-VTE had significant longer hospital stay and higher mortality rate. Patients with elder age, malignancy, ICU stay, and undergoing major surgery, particularly those with cardiopulmonary and neurological diseases, required more intensive HA-VTE surveillance and prevention.</p>