VTE and co-morbidities
To successfully evaluate a patient’s risk of VTE requires an appreciation of patient characteristics, disease characteristics and co-morbidities, and inherent risks in clinical interventions.
Many of a patient’s predisposing risk factors for VTE are co-morbid conditions that require active evaluation and management. These include cardiovascular diseases such as acute heart failure, acute myocardial infarction, and acute stroke.1 Respiratory disease, acute infection, and rheumatic disease also affect VTE risk, and cancer and its therapies are associated with a greatly increased risk of VTE. Cancer is thought to effect a six-fold increase in the risk of VTE.1
In addition, there is a known cumulative risk to the presence of multiple VTE risks.2 Among the non-modifiable risk factors for VTE are patient age, previous history of VTE, and thrombophilia. Obesity, smoking, varicose veins, hormone therapy, and immobility are other patient characteristics that adversely affect a patient’s VTE risk profile. Pregnancy and the post-partum state, gynaecological diseases, and most types of major surgery also carry a high risk of VTE.
In the sections that follow, more detailed descriptions are given of VTE risk according to different diseases and conditions, and the benefits of VTE prophylaxis are discussed.
- Geerts WH, Heit JA, et al. Prevention of venous thromboembolism. Chest. 2001;119(1 Suppl):132-75S.
- Geerts WH, Pineo GF, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 Suppl): 338S-400S.