Prevention Of Venous Thromboembolism Research Articles

Clinical Knowledge Model for the Prevention of Healthcare-Associated Venous Thromboembolism.

Knowledge models inform organizational behavior through the logical association of documentation processes, definitions, data elements, and value sets. The development of a well-designed knowledge model allows for the reuse of electronic health record data to promote efficiency in practice, data interoperability, and the extensibility of data to new capabilities or functionality such as clinical decision support, quality improvement, and research. The purpose of this article is to describe the development and validation of a knowledge model for healthcare-associated venous thromboembolism prevention. The team used FloMap, an Internet-based survey resource, to compare metadata from six healthcare organizations to an initial draft model. The team used consensus decision-making over time to compare survey results. The resulting model included seven panels, 41 questions, and 231 values. A second validation step included completion of an Internet-based survey with 26 staff nurse respondents representing 15 healthcare organizations, two electronic health record vendors, and one academic institution. The final knowledge model contained nine Logical Observation Identifiers Names and Codes panels, 32 concepts, and 195 values representing an additional six panels (groupings), 15 concepts (questions), and the specification of 195 values (answers). The final model is useful for consistent documentation to demonstrate the contribution of nursing practice to the prevention of venous thromboembolism.

Prevention and management of venous thromboembolism. International Consensus Statement. Guidelines according to scientific evidence.

Prevention and management of venous thromboembolism. International Consensus Statement. Guidelines according to scientific evidence.

Qualitative experiences, values, and decisional needs of patients with unprovoked venous thromboembolism who suffer bleeding—“This pill will keep you alive tonight”

BackgroundContemporary guidelines recommend extended-duration anticoagulation among patients with a first unprovoked venous thromboembolism (VTE). Little is known about whether this recommendation aligns with patient values after a bleeding complication. ObjectivesTo explore the experiences, values, and decisional needs of patients with unprovoked VTE related to extended-duration treatment after an anticoagulant-associated bleed. MethodsIn this descriptive, qualitative study, face to face online semistructured interviews were conducted with patients with unprovoked VTE who had experienced bleeding and continued anticoagulant treatment in one academic hospital in Canada. Data were analyzed using directed content analysis to identify themes. Themes were mapped onto the Ottawa Decisional Support Framework to identify decisional needs. ResultsBetween September and December 2021, 14 patients were interviewed (age 41-69 years; 9 females). Many patients were not aware of the option to stop anticoagulation and had limited understanding of the decision about treatment duration. Despite the negative quality-of-life impact of clinically relevant bleeding during VTE treatment, the majority continued anticoagulation due to emotional trauma of VTE diagnosis, a perception that bleeding would be more manageable than VTE recurrence, a desire to maintain a connection to subspecialty care or non-VTE related benefits (eg, cancer diagnosis, protection from COVID-19). Patients’ decisional needs included lack of choice awareness, inadequate support for participation, lack of personalized risk stratification, and inadequate information on monitoring and managing heavy menstrual bleeding. ConclusionDespite the impact of anticoagulant-associated bleeding on quality of life, patients preferred continuing with anticoagulation for reasons extending beyond secondary VTE prevention. Effective decision-support interventions are needed to address unmet decisional needs.

Safety of dabigatran

Thrombosis ranks first among the leading causes of death worldwide and is a fatal risk factor for patients’ health. Rapid diagnosis and appropriate treatment are necessary. There are three categories of antithrombotic agents: antiplatelet agents, anticoagulants, and fibrinolytics. Anticoagulants are first-line therapy for the prevention and treatment of venous thrombi. Dabigatran etexilate is a direct thrombin inhibitor. The effectiveness of dabigatran has been demonstrated in several clinical studies for the prevention of venous thromboembolism in patients undergoing total hip or total knee arthroplasty, for the prevention of stroke in patients with non-valvular atrial fibrillation, and in the treatment of acute venous thromboembolism. Some studies have demonstrated that the use of dabigatran leads to an increased risk of bleeding. Therefore, the purpose of this review is to examine the safety of dabigatran in patients over 18 years of age. We identified potentially relevant studies by searching the electronic databases PubMed, Web of Science, Cochrane Library, MEDLINE, and Google Scholar. Further, according to the inclusion and exclusion criteria, as well as by means of independent selection, all the authors of this article selected the sources that were suitable according to the criteria and compiled this review.

Therapy adherence, safety and efficacy of rivaroxaban in prevention of venous thromboembolism in patients with hip or knee endoprosthesis.

Rivaroxaban is a potent, selective direct inhibitor of factor Xa. The aim of this study was to evaluate the therapy adherence, safety and efficacy of rivaroxaban therapy in reducing the risk of venous thromboembolism in patients undergoing elective hip or knee replacement. The prospective, post-marketing clinical trial was conducted on adult patients after knee or hip endoprosthesis. Data were collected at the baseline and three control visits (five days, a month and three months after the baseline). Morisky Medication Adherence Scale (MMAS-8) was used for evaluation of therapy adherence. The study included 60 patients who received rivaroxaban therapy in a dose of 10mg once a day. A low adherence to the drug was observed in 15% patients. All patients had an average MMAS-8 score in the range of high adherence 0.65 ± 0.90. Symptomatic venous thromboembolism was observed in two patients with numerous risk factors. No major bleeding was recorded during entire follow-up period. During the five-day postoperative in-hospital follow-up, signs of wound complications were recorded in 8 (13.3%) patients, and 4 (6.7%) of them underwent surgical revision of the wound. Generally, there was high adherence to rivaroxaban therapy, but low adherence was present in 15% of patients. Rivaroxaban showed good safety and efficacy. However, high proportion of wound complications and patients needing surgical revision of the wound should be further evaluated through larger studies.

Update on the Pharmacological Actions of Enoxaparin in Nonsurgical Patients.

Low-molecular-weight heparins are a class of drugs derived from the enzymatic depolymerization of unfractionated heparin that includes enoxaparin. Several studies have been performed on enoxaparin in recent years, in particular for the prevention and treatment of venous thromboembolism and for the treatment of acute coronary syndrome. Furthermore, the use of enoxaparin has been extended to other clinical situations that require antithrombotic pharmacological prevention, such as hemodialysis and recurrent abortion. In this review, we report the main clinical experiences of using enoxaparin in the prevention of VTE in nonsurgical patients.

High microRNA-145 plasma levels are associated with decreased risk of future incident venous thromboembolism: the HUNT study

AbstractMicroRNA-145 (miR-145) has been reported to downregulate the expression of tissue factor and factor XI in vitro and decrease venous thrombus formation in animal models. However, the association between miR-145 and risk of future venous thromboembolism (VTE) in the general population remains unknown. We investigated the association between plasma levels of miR-145 and risk of future VTE in a case-cohort study. Incident VTE cases (n = 510) and a subcohort (n = 1890) were derived from the third survey of the Trøndelag Health Study (HUNT3), a population-based cohort. The expression levels of miR-145 were measured in plasma samples obtained at baseline. The study population was divided into quartiles based on miR-145 levels in participants in the subcohort, and weighted Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Plasma levels of miR-145 were inversely associated with VTE risk. Participants with miR-145 levels in the highest quartile had a 49% lower risk of VTE (HR, 0.51; 95% CI, 0.38-0.68) than those with miR-145 in the lowest quartile in age- and sex-adjusted analysis, and the inverse association was most pronounced for unprovoked VTE (HR, 0.39; 95% CI, 0.25-0.61). Risk estimates remained virtually the same after further adjustment for body mass index, and cancer and arterial cardiovascular disease at baseline. In conclusion, elevated expression levels of miR-145 in plasma were associated with decreased risk of future incident VTE. The protective role of miR-145 against VTE is consistent with previous experimental data and suggests that miR-145 has the potential to be a target for VTE prevention.

Prevention of venous thromboembolism in surgical patients: A proposal for a protocol based on the reality of a university hospital

Introduction: Venous thromboembolism (VTE) results from the formation of thrombi in the endothelial space, following factors related to endothelial injury, venous stasis and coagulation disorders. This scenario can result in deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE), which is the third leading cause of cardiovascular death worldwide. Given the possibility of preventing VTE in the majority of in-hospital cases, it is recommended that every hospital has a formal strategy for VTE prevention, including in patients undergoing elective surgery. To this end, it is possible to use risk stratification scales, both for the development of VTE and the baseline risk of bleeding in post-operative patients. Objective: To provide an institutional protocol that is systematized and updated according to the main national and international literature on the prevention of venous thromboembolism in elective surgeries at the Júlio Muller University Hospital (HUJM/ UFMT). Materials and Methods: A protocol was drawn up based on a systematic analysis of up-to-date scientific evidence on thromboprophylaxis in elective surgeries, adapted to the routine of the Júlio Muller University Hospital (HUJM/UFMT), using the UpToDate, Pubmed and Cochrane Library platforms, as well as the Guidelines of the Brazilian Society of Angiology and Vascular Surgery (SBACV) and the American College of Chest Physicians (ACCP). Conclusion: The patient's risk of developing VTE is largely due to avoidable or predictable risk factors, depending on the type of surgery, mobilization time and risk of bleeding. The use of a protocol for the prevention of venous thromboembolism through risk stratification will allow greater individualization of the patient in relation to established prophylaxis, based on scientific evidence. Further studies on the subject are still needed, especially in the setting of elective surgery.

Venous Thromboembolism in Children: The Rivaroxaban Experience.

The incidence of venous thromboembolism (VTE) in the pediatric population has increased more than 10-fold in the last 20 years, as a consequence of the advancement of resuscitation and surgical techniques and the global increase in life expectancy of children suffering from chronic pathologies. Monitoring anticoagulant therapy to achieve outcomes within the target range in childhood VTE, parenteral administration of medications, and frequent blood tests in children are often cumbersome. Availability of safe and effective oral agents with pediatric data to support use would be of clear benefit. A physiologically based pharmacokinetic model was developed to estimate the appropriate dosing schedule for rivaroxaban in children. This incorporated growth/maturation and variability in anthropometrics (e.g., body height, weight, and body mass index), anatomy (e.g., organ weight), physiology (e.g., blood flow rates), metabolism and excretion. Rivaroxaban use in pediatric population underwent a complete investigational program, consisting mainly of one phase I pharmacokinetics/pharmacodynamics trial, three phase II trials, one phase III trial. The phase III trial enrolled 500 patients from birth to <18 years and documented the efficacy and safety of rivaroxaban regimens at dose equivalent to the adult 20 mg dose for the prevention of fatal or symptomatic nonfatal recurrent VTE and major bleeding versus heparin or vitamin K antagonists. Results were similar to those in rivaroxaban studies in adults. The efficacy and safety of rivaroxaban in children reported in the EINSTEIN JUNIOR trial provide further support to previous trials in adults (EINSTEIN Program), which demonstrate a favorable profile for the use of rivaroxaban for the management of VTE in challenging patient populations. Other clinical evidence contributing to the use of rivaroxaban among different risk groups in pediatric VTE population confirms the consistency with principal trial. Our review aims to describe the rationale for using rivaroxaban oral suspension in clinical practice and to summarize its multiple indications in each vascular bed (e.g., cerebral venous thrombosis, symptomatic or asymptomatic central venous catheter-associated thrombosis), etiology, and patients setting.

Effect of a Self-instructional Module on Clinical Nurses’ Knowledge and Practice Regarding Prevention of Venous Thromboembolism in Post-operative Patients

Abstract This pre-experimental study was done to assess the effect of a self-instructional module on clinical nurses’ knowledge and practice regarding the prevention of venous thromboembolism (VTE) in post-operative patients. The sample consists of 30 clinical nurses working in post-operative ICUs selected by purposive sampling technique. The tools used were a self-administered structured questionnaire on socio-demographic data and knowledge and an observation checklist on practice regarding the prevention of VTE. The study findings revealed that there was a significant difference between the pre-test and post-test knowledge and practice scores as the mean knowledge score of the post-test (16.93 ± 2.82) is higher than the pre-test score (13.70 ± 3.35) and the mean practice score of post-test (3.06 ± 1.17) is higher than the pre-test score (2.16 ± 0.74). There was a weak positive correlation between knowledge and practice scores (r = 0.08). The study findings also showed that there was no significant association between the pre-test level of knowledge and practice with selected demographic variables such as age, gender, qualification, total years of experience, previous knowledge on VTE and source of information. It can be concluded that the self-instructional module is effective in improving the knowledge and practice of clinical nurses in the prevention of VTE.

Effect of venous foot pump intervention on prevention of venous thromboembolism in patients with major orthopedic surgery: a systematic review and meta-analysis.

Venous thromboembolism (VTE) is a common complication after major orthopedic surgery. The venous foot pump (VFP) is an effective mechanical preventive measure against VTE in patients. However, the differences in effectiveness based on varying usage times of VFP remain unclear. To explore the effectiveness of VFP with different usage times in preventing VTE in patients undergoing major orthopedic surgery. Nine databases (PubMed, Web of Science, CINAHL, Embase, Cochrane Library, CBM, VIP, CNKI, and Wanfang) were searched to identify randomized controlled trials (RCTs) evaluating VFP interventions for VTE prevention in major orthopedic surgery patients. The risk of bias in each study was assessed using the Cochrane Collaboration tool. Meta-analysis was conducted using RevMan 5.3. A total of 36 RCTs involving 3,791 patients undergoing major orthopedic surgery were included. Meta-analysis revealed significant differences in VTE incidence between the VFP and blank control groups (RR = 0.27, 95% confidence interval CI: 0.19-0.38, P < 0.001) and between the VFP plus chemoprophylaxis and chemoprophylaxis alone groups (RR 0.39, 95% CI: 0.29-0.53, P < 0.001). However, no statistically significant difference was observed between the VFP and the LMWH groups (RR = 0.93, 95% CI: 0.54-1.61, P = 0.8). Subgroup analysis showed no significant difference in effectiveness based on different VFP usage durations (VFP vs. Blank: Chi-square = 0.54, P = 0.46, I2 = 0%; VFP Plus chemoprophylaxis vs. chemoprophylaxis alone: Chi-square = 1.93, P = 0.86, I2 = 0%). The current evidence indicates that VFP significantly reduces the incidence of postoperative VTE in patients undergoing major orthopedic surgery. VFP can be considered an add-on strategy to LMWH for patients at low risk of bleeding and an alternative strategy to LMWH in patients at high risk of bleeding. This study found no significant difference in effectiveness between various VFP usage interventions. Future research should focus on economic cost-effectiveness and patient acceptance to help policymakers determine the most efficient usage duration, providing practical guidance for thromboprophylaxis.

Risk Factors of In‐Hospital Venous Thromboembolism and Prognosis After Emergent Ventral Hernia Repair

Background: The risk factors and association of venous thromboembolism (VTE) following emergent ventral hernia repair (EVHR) remains uncertain. This aim of the study aims was to establish the predictors of VTE after EVHR and its influence on the long‐term outcomes.Methods: A total of 2093 patients from the MIMIC‐IV database who underwent EVHR were recruited. Multivariate logistic regression and nomogram models were developed to predict in‐hospital VTE and mortality. Calibration and receiver operating characteristic (ROC) curves were utilized to assess the model’s effectiveness and reliability. Decision curve analysis (DCA) was performed to evaluate the net clinical benefits of the model.Results: The rate of in‐hospital VTE was 1.6% (33/2093) after EVHR. Four independent potential factors were established after multivariate analysis, and the abovementioned risk factors fit into the nomogram. The prediction model presented good performance metrics (C‐index: 0.857), the calibration and ROC curves demonstrated the accurate prediction power, and DCA indicated the superior net benefit of the established model. In‐hospital and 1‐year mortality rates were 0.8% (17/2093) and 4.1% (86/2076) after EVHR. The potential factors were included in the mortality prediction nomogram. The prediction model presented good performance metrics (C‐index of 0.957 and 0.828, respectively), the calibration and ROC curves were consistent with the actual results, and DCA indicated the superior net benefit of the established model.Conclusion: The nomogram, derived from the logistic regression model, demonstrated excellent predictive performance for VTE occurrence and prognosis in patients following EVHR. This model could serve as a valuable reference for clinical decision‐making regarding VTE prevention and for enhancing post‐EVHR prognosis.

Prevention and control of venous thromboembolism after major orthopedic surgery through doctor-to-patient cultivation of musculoskeletal ability based on King's theory of goal attainment.

To explore the prevention and management of venous thromboembolism (VTE) following major orthopaedic surgery (MOS) by fostering doctor-to-patient cultivation of musculoskeletal ability, guided by King's theory of goal attainment. A cohort of patients (n = 116) undergoing MOS was selected for the study, and were divided into two groups: the regular group and the observation group, with patients in the regular group experiencing routine nursing care and management and those in the observation group undergoing musculoskeletal ability cultivation based on King's theory of goal attainment. Baseline data, limb vascular ultrasonography, coagulation function, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, VTE prevention efficacy, Exercise of Self-care Ability Scale (ESCA) score, and nursing satisfaction were analysed comparatively. There was no significant within-group difference in baseline data (P > 0.05). Following the interventions, the observation group demonstrated statistically significant reductions in the Musculoskeletal-Integrated Imaging Score, various dimensions of WOMAC scores, and D-dimer (D-D) levels (P < 0.05) both in comparison to their levels before interventions and to those observed in the regular group (P < 0.05). Additionally, the observation group exhibited increases in prothrombin time levels and various dimensions of ESCA scores (P < 0.05) post-intervention, surpassing the pre-intervention levels and those obtained in the regular group (P < 0.05). Furthermore, the observation group exhibited a significantly lower incidence of VTE (P < 0.05) and higher nursing satisfaction (P < 0.05) compared to the regular group. Nursing intervention measures, utilizing doctor-to-patient cultivation of musculoskeletal ability based on King's theory of goal attainment, have demonstrated a significant clinical benefit for VTE prevention and control in post-MOS patients. This approach not only effectively prevented VTE in post MOS patients but also enhanced their satisfaction towards nursing care.

Efficacy and safety of direct oral anticoagulants for preventing venous thromboembolism in hospitalized cancer patients: a national multicenter retrospective cohort study.

Studies on the use of direct oral anticoagulants (DOACs) for preventing venous thromboembolism (VTE) in hospitalized cancer patients are lacking. Therefore, we conducted a multicenter retrospective cohort study to evaluate the efficacy and safety of DOACs versus low-molecular-weight heparin (LMWH) for the primary prevention of VTE in hospitalized cancer patients. Clinical outcomes included thrombosis, VTE, other thrombosis, all bleeding, major bleeding, nonmajor bleeding, and all-cause death. A 1:1 cohort of rivaroxaban and LMWH patients was created by propensity score matching. A total of 2,385 cancer patients were included in this study. During the 3-month follow-up period, 129 (5.4%) thrombosis events occurred, 63 (2.7%) of which were VTEs and 66 (2.8%) of which were other thrombosis events. All bleeding occurred in 163 (6.8%) patients, 68 (2.9%) had major bleeding, and 95 (4.0%) had nonmajor bleeding. All-cause deaths occurred in 113 (4.7%) patients. After adjusting for various confounders, the incidence of thrombosis and other thromboses was significantly lower in the rivaroxaban group than in the LMWH group [OR 0.543, 95% CI (0.343-0.859), p = 0.009; OR 0.461, 95% CI (0.241-0.883), p = 0.020]. There were no significant differences in incidence of VTE, total bleeding, major bleeding, nonmajor bleeding, or all-cause death. In oncology patients receiving thromboprophylaxis, rivaroxaban has a lower incidence of thrombosis and other thrombosis and a similar incidence of VTE as LMWH and does not increase the risk of bleeding. Rivaroxaban may be an attractive alternative to LMWH for preventing VTE in hospitalized cancer patients.

Effect of heparin for the prevention of venous thromboembolism in patients with spontaneous intracranial cerebral hemorrhage: a meta-analysis.

Venous thromboembolism (VTE) has a serious impact on the prognosis of patients with spontaneous intracranial hemorrhage (sICH). However, the use of prophylactic heparin remains controversial. This study investigated the safety and timing of prophylactic heparin for VTE in patients with sICH. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Two authors systematically searched Web of Science, Cochrane Library, Embase, and PubMed to find all published research before June 2023. The incidence of deep venous thrombosis (DVT) and mortality were set as primary endpoints. This meta-analysis included seven randomized controlled trials (RCTs) and five observational studies involving a total of 4419 sICH patients in the heparin (n = 2808) and control (n = 1183) groups. Among these patients, 205 received early heparin administration, while 223 received late heparin administration. The results suggested that, compared to the control group, patients in the heparin group had a lower incidence of VTE [odds ratio (OR), 0.47; 95% CI, 0.31-0.71; p < 0.001], DVT (OR, 0.53; 95% CI, 0.33-0.85; p = 0.009), pulmonary embolism (OR, 0.31 95% CI, 0.15-0.65; p = 0.002), and mortality (OR, 0.70; 95% CI, 0.54-0.90; p = 0.006), but there were no statistical differences in hematoma enlargement, extracranial hematoma, and major disability (p > 0.05). There was no statistically significant difference in DVT, mortality, hematoma enlargement, and extracranial hemorrhage between the early heparin group (<24-48 h) and the late heparin group (p > 0.05). In patients with sICH, prophylactic use of heparin may be beneficial because it reduces the incidence of VTE and mortality without increasing the risk of additional bleeding. In addition, early prophylactic use of heparin appears to be safe. However, large-scale RCTs are lacking to support this evidence.

Retrospective cross-sectional analysis of concurrent VTE diagnosis in hospitalised socially excluded individuals in Ireland

ObjectiveSocial exclusion (such as that experienced by people who are homeless, incarcerated or use drugs) increases morbidity across a range of diseases but is poorly captured in routine data sets....

Serum Bilirubin Levels and Risk of Venous Thromboembolism among Influenza Patients: A Cohort Study.

This study aimed to investigate the associations between total serum bilirubin levels and the incidence of venous thromboembolism (VTE) among patients with influenza infection. A retrospective cohort study was conducted among outpatients with laboratory-confirmed influenza using data from the Veterans Affairs Informatics and Computing Infrastructure (VINCI). Propensity score weighting was applied to balance study groups across baseline covariates. Cox proportional hazards models assessed VTE risk by total bilirubin levels, adjusting for important covariates including age, sex, race, comorbidity index, BMI, and smoking status. A total of 487 patients with total bilirubin levels <0.3 mg/dL, 8608 patients with levels between 0.3-1 mg/dL, and 1148 patients with levels >1 mg/dL were included. Patients with bilirubin <0.3 mg/dL exhibited a 6-fold higher risk of VTE compared to those with levels 0.3-1 mg/dL within 30 days of infection (HR = 6.2, 95% CI = 1.46-26.42). Elevated risks were noted through 90 days post infection (HR = 4.71, 95% CI = (1.42-15.67)). Serum bilirubin levels, particularly below 0.3 mg/dL, were significantly associated with an increased risk of VTE among individuals with influenza. These findings suggest that lower bilirubin levels may contribute to heightened inflammatory responses and subsequent thromboembolic events in patients with influenza. The underlying mechanisms and potential therapeutic implications for VTE prevention among patients with acute respiratory infection warrants further consideration.

Risk Factors of Bleedings in Patients with COVID-19 Receiving Anticoagulants for Venous Thromboembolism Prevention

Risk Factors of Bleedings in Patients with COVID-19 Receiving Anticoagulants for Venous Thromboembolism Prevention

Application of integrated medical information management system in the risk assessment and prevention of perioperative venous thromboembolism in gynecological patients

Application of integrated medical information management system in the risk assessment and prevention of perioperative venous thromboembolism in gynecological patients

Nomogram for predicting venous thromboembolism after spinal surgery

PurposeThis study aimed to establish a nomogram to predict the risk of venous thromboembolism (VTE), identifying potential risk factors, and providing theoretical basis for prevention of VTE after spinal surgery.MethodsA retrospective analysis was conducted on 2754 patients who underwent spinal surgery. The general characteristics of the training group were initially screened using univariate logistic analysis, and the LASSO method was used for optimal prediction. Subsequently, multivariate logistic regression analysis was performed to identify independent risk factors for postoperative VTE in the training group, and a nomogram for predict risk of VTE was established. The discrimination, calibration, and clinical usefulness of the nomogram were separately evaluated using the C-index, receiver operating characteristic curve, calibration plot and clinical decision curve, and was validated using data from the validation group finally.ResultsMultivariate logistic regression analysis identified 10 independent risk factors for VTE after spinal surgery. A nomogram was established based on these independent risk factors. The C-index for the training and validation groups indicating high accuracy and stability of the model. The area under the receiver operating characteristic curve indicating excellent discrimination ability; the calibration curves showed outstanding calibration for both the training and validation groups. Decision curve analysis showed the clinical net benefit of using the nomogram could be maximized in the probability threshold range of 0.01–1.ConclusionPatients undergoing spinal surgery with elevated D-dimer levels, prolonger surgical, and cervical surgery have higher risk of VTE. The nomogram can provide a theoretical basis for clinicians to prevent VTE.