Risk Assessment, Prophylaxis, and Treatment Among Hospital-Acquired VTE in China

BACKGROUND: Venous thromboembolism (VTE) is a common preventable cause of unexpected mortality in hospitalized patients. However, in-hospital and postdischarge VTE management status in China remains unclear. OBJECTIVES: The authors aimed to investigate real-world VTE risk evaluation, prevention, and treatment among hospitalized VTE patients nationwide. METHODS: We conducted a nationwide, retrospective, prospective, multicenter cohort study of Chinese venous thromboembolism in inpatients between January 2021 and September 2023 across 76 hospitals in China (registration number: ChiCTR2100047692). This study included patients with radiologically confirmed in-hospital VTE. VTE and bleeding risks were assessed within 24 hours of admission using hospital information system-embedded tools. Prophylaxis and treatment strategies followed each hospital's VTE protocols. Patients were followed up via telephone or outpatient visits at 1, 3, and 6 months postdischarge. RESULTS: A total of 1,184 patients were included, with a median follow-up duration of 181 (IQR: 68-194) days. Bleeding risk increased proportionally with VTE risk, with nearly all patients at bleeding risk classified as having a moderate or higher VTE risk. Among patients with confirmed VTE diagnosis, 42.6% (504/1,184) received any form of prophylaxis (mechanical, pharmacologic, or combined prophylaxis). Low-molecular-weight heparin and graduated compression stockings were the predominant in-hospital pharmacologic and mechanical interventions, respectively. Postdischarge, direct oral anticoagulants and graduated compression stockings were the primary therapeutic options. CONCLUSIONS: This study demonstrates the need for improved standardization of VTE risk assessment, prophylaxis, and treatment practices in China to prevent hospital-acquired VTE and optimize patient outcomes.