NIRCO med‎ > ‎periop‎ > ‎assessment‎ > ‎01 cardiovascular‎ > ‎thrombotic risk‎ > ‎

venous thromboembolism

Epidemiology:
  • Prevalence: overall rate of thrombosis (with and without bridging therapy) is 1.8% among patients with venous thromboembolism (1).
  • Risk factors:
    • Low annual risk (<5% thromboembolism/y): venous thromboembolism >12 mo previously and no other risk factor (e.g., provoked or transient) (1).
    • Moderate annual risk (5-10% thromboembolism/y): venous thromboembolism within previous 3-12 mo, nonsevere thrombophilia (heterozygosity for factor V Leiden or prothrombin G20210A variant (2)), or recurrent venous thromboembolism (1).
    • High annual risk (>10% thromboembolism/y): venous thromboembolism within previous 3 mo, severe thrombophilia (protein C, protein S or antithrombin deficiency; has the antiphospholipid syndrome (presence of antiphospholipid antibodies or lupus anticoagulant); is homozygous for factor V Leiden; is homozygous for prothrombin G20210A variant; or has compound heterozygous mutations of these two genes (2)), unprovoked venous thromboembolism or active cancer (cancer diagnosed <=6 mo or patient undergoing cancer therapy (3)) (1).
References:
  1. Current Concepts: Management of Antithrombotic Therapy in Patients Undergoing Invasive Procedurs. NEJM. 2013;368(22):2113-2124: full text | pdf.
  2. Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:6 Suppl:844S-886S: full text | pdf.
  3. DVT: A New Era in Anticoagulant Therapy: Periprocedural Anticoagulation Management of Patients With Venous Thromboembolism. Arteriosclerosis, Thrombosis, and Vascular Biology. 2010;30:442-448: full text | pdf.