The pooled 90-day incidence of post-hospitalization VTE was 2.9% in medical patients compared with 1.3% in surgical patients, with medical patients exhibiting a prolonged risk.
Meta-Analysis (n=9,152,616)
Does the duration and rate of post-hospitalization VTE risk differ between surgical and medical patients?
Medical patients exhibit a prolonged VTE risk post-hospitalization compared to surgical patients, whose risk is predominantly short-term.
Absolute Event Rate: 2.9% vs 1.3%
OBJECTIVE: Hospitalization increases venous thromboembolism (VTE) risk, and over one-half of all VTE events occur after hospital admission. Current decisions on post-hospitalization VTE prophylaxis are not evidence-based. The duration of enhanced risk after hospitalization, in surgical and medical patients, is not well-known. In this meta-analysis, we evaluated the rates of post-hospitalization VTE over time in patients that underwent surgery during their hospitalization and those that did not. METHODS: A literature search was performed through November 2023 using PubMed, EMBASE, and Cochrane. Studies examining the incidence of VTE in hospitalized patients during a specified period following hospitalization were included. Studies were excluded if they focused on nonhospitalized patients, failed to define the follow-up duration, or did not report the incidence of VTE. Screening and data collection was conducted by two reviewers. RESULTS: From a total of 1504 studies screened, 57 were included. Overall, 9,152,616 patients were included; of these, 1,232,627 were followed for 30 days, 28,522 for 45 days, 2,515,940 for 90 days, and 5,375,527 were followed beyond 90 days. The pooled incidence of VTE during the first 45 days was 0.3% (95% confidence interval CI, 0.2%- 0.4%) among surgical patients and 4.6% (95% CI, 4.3%-4.9%) among medical patients. The pooled incidence of VTE during the first 90 days was 1.3% (95% CI, 0.7%-2.3%) in surgical patients and 2.9% (95% CI, 2.0%-4.1%) in medical patients. Beyond 90 days (between 180 and 1020 days), the pooled incidence of VTE was 1.0% (95% CI, 0.4%-2.3%) in the surgical cohort, compared with 2.3% (95% CI, 1.6%-3.5%) in the medical cohort. CONCLUSIONS: The post-hospitalization 90-day VTE rate was found to be low for both surgical and medical patients; the risks beyond 90 days was found to be only slightly lower. VTE risk in surgical patients is predominantly short-term and diminishes following recovery from surgery. Conversely, medical patients exhibit a prolonged VTE risk, likely related to persistence of clinical risk factors.
Jreij et al. (Sat,) conducted a meta-analysis in Venous thromboembolism (n=9,152,616). Medical hospitalization vs. Surgical hospitalization was evaluated on Incidence of VTE during the first 90 days. The pooled 90-day incidence of post-hospitalization VTE was 2.9% in medical patients compared with 1.3% in surgical patients, with medical patients exhibiting a prolonged risk.