Wang et al identified risk factors for venous thromboembolism in hospitalized patients receiving thromboprophylaxis. These can help to identify a patient who may require more aggressive management. The authors are from Washington University, Ohio State University and BJC HealthCare in Saint Louis.

Patient selection: hospitalized patient on thromboprophylaxis


Risk factors for venous thromboembolism:

(1) hospitalization for cranial surgery (odds ratio 16.1)

(2) admission to the intensive care unit (ICU, odds ratio 3.0)

(3) admission white blood cell count > 13,000 per µL (odds ratio 2.7)

(4) indwelling central venous catheter (odds ratio 2.5)

(5) admission from a long-term care facility (odds ratio 2.1


In univariate analysis a venous thromboembolism in the past year had a p value of 0.13. Other history of thromboembolism not reported. A person with significant hypercoagulable state might be on therapeutic anticoagulation and so excluded.


Interventions in a patient considered high risk:

(1) aggressive early ambulation

(2) use of enoxaparin for thromboprophylaxis rather than unfractionated heparin

(3) use of mechanical interventions

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