Risk factors and incidence of venous thromboembolism in internal medicine:a prospective study on 947 in patients

Purpose. - The thromboembolic risk is difficult to evaluate in medical inpa tients because of the multiplicity of risk factors. The lack of scientific data leads to a certain empiricism in selection of patients who need a prev entive treatment. Methods. - All patients hospitalised in an internal medicine department wer e included during 34 months. The pathogenic mechanism of risk factors (veno us stasis or hypercoagulability) was analysed as well as their progress (tr ansient or permanent risk factors) and their pathogenic weight (major risk factor or not). Three levels of embolic risk (high, intermediate, low) were identified. A preventive treatment was initiated only for patients at high or intermediate risk. A clinical screening for thromboembolic events was p erformed daily. Therefore, we have excluded patients who needed a hypocoagu lant treatment. Results, - Nine hundred and forty-seven patients were included. Age (over 6 0) was the most frequent permanent risk factor (70%). Bed rest was the most frequent transient risk factor responsible for venous stasis. Fifty percen t of patients had a transient and permanent risk factor and needed a preven tive treatment according to our selection criteria. The incidence of thromb oembolic events was 0.4% in the high-risk treated group and 0.2% in the low -risk non-treated group. Conclusions. - Venous stasis factors are the more frequent risk factor in i nternal medicine, perhaps because of the increasing number of geriatric pat ients. The incidence of thromboembolic disease is low in high-risk inpatien ts when a preventive treatment is performed (C) 2001 Editions scientifiques et medicales Elsevier SAS.