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American Journal of Medicine
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American Journal of Medicine
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The risk factors for venous VTE are well described[1] and they can be broadly divided into exposing risk factors, which are often acute triggers, and predisposing risk factors, which are often chronic conditions that are characteristics of the patient (Figure 3).
When we think of exposing risk factors, we think of surgery, trauma, acute illnesses (such as heart failure or respiratory disease), and we think of patients who have catheters placed, whether as an arm vein catheter or a central venous catheter. These risk factors that can trigger thrombosis put patients at risk for as long as the risk factor is present – although once the risk factor is gone, the patient no longer has the risk.
Predisposing risk factors generally persist long-term; these may be a history of venous thrombosis; a condition such as chronic heart failure; older age; long-term immobilization, for example due to a prior stroke; and a genetic predisposition to VTE.
It is important to bear the two types of risk factors in mind, because by using this information we can also project the risk of recurrence of VTE and thus begin to plan the duration of treatment. Eikelboom J. Am J Med 2013; published on-line at http://education.amjmed.com/00000.
[1] Geerts WH et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126(3 Suppl):338S-400S.