Venous Thromboembolism Risk Assessment and Prophylaxis Modalities in Critically Ill Patients

Abstract

Venous thromboembolism (VTE) is a common complication observed among critically ill patients and is associated with significant mortality and morbidity. Thus, this prospective study was conducted to assess VTE and bleeding risk factors, and prophylaxis modalities were given for critically ill patients. A total of 80 patients admitted for >2 days in the Intensive Care Unit (ICU) of a tertiary care hospital, aged >18 years old were included in this study. Patients’ demographic data, VTE risk, bleeding risk factors, and VTE prophylactic methods were reviewed from the patients’ medical records. Among the 80 patients, 65 (81.3%) had high VTE risk and 15 (18.8%) had moderate VTE risk. A total of 64 (80%) patients were at high risk of bleeding and 16 (20%) were at low bleeding risk. The most common risks observed were advanced age, male, severe renal impairment, and active bleeding. A total of 45 (56.25 %) patients received VTE thromboprophylaxis. Thromboembolic deterrent (TED) stocking was the most commonly used prophylactic method (n = 15, 33.33%) followed by unfractionated heparin (UFH) (n = 6, 13.33%). Overall, appropriate VTE prophylaxis was given (63.7%; p = 0.0188) based on VTE and bleeding risks during the study period. In conclusion, there is a significant risk for VTE among critically ill patients. This study outlines the need to implement both VTE and bleeding risk stratification strategies in all critically ill patients and highlight the need to provide adequate thromboprophylaxis when indicated.