Res Pract Thromb Haemost. 2026 Apr 30;10(4):106625. doi: 10.1016/j.rpth.2026.106625. eCollection 2026 May.
ABSTRACT
BACKGROUND: Hospitalized medical patients are at increased risk of venous thromboembolism (VTE). Current VTE-risk assessment models do not adequately identify which patients would benefit most from prophylaxis, with some low-risk individuals receiving unnecessary anticoagulation and some high-risk patients receiving inadequate protection. A clearer understanding of the risk factors most strongly associated with VTE in this population is needed.
OBJECTIVES: A systematic review and meta-analysis were conducted to identify risk factors associated with VTE in acutely ill medical patients.
METHODS: The review was registered on the PROSPERO international prospective register of systematic reviews (CRD42024584005). We searched electronic databases from inception to April 2025 for studies that analyzed risk factors associated with VTE in hospitalized medical patients or within 90 days of discharge. Methodological quality was assessed using the Risk of Bias in Nonrandomized Studies-of Interventions tool, and the certainty of evidence for each risk factor was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Findings were summarized narratively and by performing a random-effects meta-analysis.
RESULTS: Of 3804 studies identified, 18 met the inclusion criteria. Risk factor associations were reported using regression analyses, nonparametric tests, and descriptive statistics. A history of cancer or current cancer diagnosis; a history of VTE; acute infection; and comorbidities, including diabetes, atrial fibrillation, ischemic stroke, and hypertension, were the most frequently reported risk factors positively associated with VTE. All studies were assessed as having moderate or serious risk of bias. Using the GRADE approach, a history of VTE was the only risk factor graded as having moderate-certainty evidence.
CONCLUSION: Further work is needed to improve our understanding of which VTE-risk factors are most relevant to medical inpatients.
PMID:42318434 | PMC:PMC13272504 | DOI:10.1016/j.rpth.2026.106625