The risk of symptomatic venous thromboembolism in hospitalised patients with active cancer

Introduction Up to 75% of fatal pulmonary emboli in general hospitals occur in non-surgical patients immobilised by medical illness, Audits demonstrate that thromboprophylaxis is used in less than one-third of suitable patients, People with active cancer appear to be at significantly higher risk of symptomatic venous thromboembolism (VTE) than those without in epidemiological studies, Aim To determine the risk of symptomatic VTE, occurring during hospitalisation and within 90 days of discharge, in acutely ill patients with active cancer admitted to the Royal Hobart Hospital (RHH), Methods A retrospective cohort study was conducted, Medical records from patients admitted to the RHH oncology units from 1/1/04 to 31112/06 were assessed for symptomatic VTE, Patients were identified for inclusion if they had active cancer, were hospitalised for at least four consecutive days, and aged over 18 years, Results 237 patients were included, 81.4% were eligible to receive thromboprophylaxis according to hospital guidelines, Of these patients, 30,6% received prophylaxis during their hospital stay, The patients who developed VTE had a mean of 5,6 risk factors for VTE, The incidence of symptomatic VTE during the index admission and within 90 days of hospital discharge was 4,2%, Patients with previous history of VTE had a significantly higher risk of a recurrent event (P < 0,01), Of those who developed VTE, 40,0% (4 of 10) received prophylaxis during their index admission,