Retrospective cohort study. To determine whether preoperative D-dimer predicts perioperative venous thromboembolism (VTE) risk in spine tumor patients. Venous thromboembolism (VTE) is a common perioperative complication in spine surgery. Though oncologic spine patients are at particularly high risk, few studies have investigated risk factors and screening measures for predicting VTE risk in this population. Medical records of adult surgical spine tumor patients from January 2021-September 2024 were retrospectively reviewed. Preoperative D-dimer was compared between patients who did and did not develop VTE. Age, sex, tumor type, spinal level, comorbid diabetes, and ambulatory status were assessed as risk factors. Differences between groups were tested using chi-square or Fisher's exact tests for categorical and t-test or Mann-Whitney for continuous variables. Multi-group comparisons by tumor type included adjusted pairwise analyses. Receiver operating characteristic (ROC) curves and area under the curve (AUC) evaluated the diagnostic performance of D-dimer, with optimal threshold determined by Youden Index. Results are presented as means  SD. Among the 134 patients, deep vein thrombosis (DVT) and pulmonary embolism (PE) incidences were 6.7% and 9.0% respectively. Patients who developed PE had higher D-dimer levels (2,088±2,114ng/mL) than those who did not (1,222±1,743ng/mL) (P=0.025). D-dimer was not significantly associated with DVT development. Preoperative D-dimer predicted VTE risk with sensitivity 0.88, negative predictive value 0.97, and AUC 0.67 (95% CI 0.55-0.78). Age, sex, tumor type, spinal level, ambulatory status, and diabetes were not associated with VTE risk. Preoperative D-dimer is a sensitive but non-specific tool for predicting VTE in spine tumor patients. It may be more useful in predicting PE than DVT and may help guide anticoagulation prophylaxis.

Oral Janus kinase inhibitors (JAKi) are effective in managing moderate-to-severe atopic dermatitis (AD), but concerns regarding venous thromboembolism (VTE) risk persist, particularly in female patients with overlapping risk factors such as oral contraceptive pill (OCP) use and nicotine exposure (primarily smoking). We evaluated VTE events in this population using data from the abrocitinib clinical trial program. We reviewed the Phase II and Phase III clinical trial data (JADE program) for abrocitinib in AD, focusing on VTE incidence in female patients with documented OCP use and nicotine exposure to contextualize thromboembolic risk. VTE events were rare. Nonfatal VTE incidence was low, with dose-specific incidence rates less than 1.0 per 100 patient-years (PY). Among female patients taking OCPs and current or former smokers, no VTEs occurred (0 of 78). In the overall active study group, most VTEs arose in patients with multiple baseline risk factors (eg, obesity, immobilization, prior thrombosis). Discontinuation due to VTE-related adverse events was infrequent (n=7, 0.13/100 PY) in the overall study group. No VTE-related deaths were reported. Comparative rates were consistent with or lower than background risk in AD populations with similar demographics. This review is limited by the lack of publicly available patient-level data, possible underreporting of lifestyle risk factors, inability to quantify total nicotine exposure, small sample size, and unmeasured confounding variables. VTE events in female patients with AD treated with abrocitinib, including those taking OCPs and with nicotine exposure, were rare and generally associated with multiple concurrent risk factors for VTE. No VTE events were noted in female patients treated with abrocitinib who were taking OCPs and with history of smoking/nicotine exposure. These findings may help contextualize VTE risk in real-world treatment decisions.

Venous thromboembolism (VTE) is associated with increased mortality and morbidity in patients with cancer. Existing risk prediction models are typically validated within individual sites, a fragmented approach that limits clinical adoption. To validate the electronic health record cancer-associated thrombosis (EHR-CAT) score compared with the benchmark Khorana score in a contemporary cohort of patients with cancer across the nation, before and after treatment, excluding those at high risk of bleeding. This prognostic study included patients in a nationwide longitudinal EHR database from January 2018 to December 2023 with follow-up continuing to April 2025. Patients with newly diagnosed, invasive, solid, or hematologic malignant neoplasms (defined using validated International Statistical Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] algorithms) receiving systemic therapy (defined using the first antineoplastic medication) were included. Those with recent history of acute VTE diagnosis or anticoagulant prescription were excluded. Demographics, risk model variables, and common anticoagulant trial exclusion criteria (as a proxy for identifying people at high risk of bleeding) were extracted on or before index therapy initiation date. Incident VTE and bleeding outcomes at 6 months were defined using validated ICD-10-CM algorithms. A total of 732 594 patients (median [IQR] age, 65.0 [56.9-73.0] years; 425 124 female [58.0%]; 25 634 Asian [3.5%], 94 269 Black [12.9%], 48 266 Hispanic [6.6%], 583 047 White [76.9%]) with active cancer receiving systemic therapy between 2018 and 2023 from 184 health systems were identified. With a median (IQR) follow-up of 676 (340-1151) days, the incidence of 6-month VTE, bleeding, and mortality was 4.7% (34 499 patients), 3.7% (26 993 patients), and 8.4% (60 239 patients), respectively. Bleeding risk was higher in the 26.0% of patients (190 413) meeting anticoagulant trial exclusion criteria (7.2% vs 2.4%; hazard ratio, 2.5 [95% CI, 2.5-2.5]). The EHR-CAT score stratified patients into discriminative risk groups (C statistic, 0.70-0.71) both before and after exclusion for bleeding risk. When compared with the benchmark Khorana score (C statistic, 0.63), EHR-CAT reclassified 20% of patients into revised categories with improved prediction accuracy. Furthermore, EHR-CAT had consistent calibration in subgroups by age, sex, race, ethnicity, and individual health system sites. This prognostic study of the EHR-CAT risk score demonstrated the external validity and feasibility of using readily available structured EHR data to estimate VTE risk in patients with cancer.

Introduction: Venous thromboembolism (VTE) is an important complication after spontaneous intracerebral hemorrhage (ICH). However, it remains a clinical challenge to identify individuals at high risk for VTE in a population with ICH. This study aimed to develop a model integrating cardiac biomarkers with clinical-radiological factors for predicting VTE risk in patients with spontaneous ICH. Methods: ICH patients were retrospectively enrolled between October 2019 and December 2022. Baseline clinical characteristics, laboratory data, and radiological features were collected. Patients with pulmonary embolism (PE) and deep vein thrombosis were classified into the VTE group. Cox regression analysis was used to identify independent predictors of in-hospital VTE. A nomogram was developed based on the multivariate model, and its performance was evaluated using the concordance index (C-index), decision curve analysis, and net reclassification improvement. Results: A total of 170 patients (mean age: 54.66 ± 13.6 years, 125 [73.5%] males) with ICH were included in the analysis. Thirty-six (21.2%) patients were assigned to the VTE group. Multivariate Cox analysis identified age (HR = 1.032, 95% CI: 1.002–1.062, p = 0.033), baseline edema volume (HR = 1.034, 95% CI: 1.012–1.056, p = 0.002), intraventricular hemorrhage (HR = 3.268, 95% CI: 1.635–6.530, p < 0.001), myoglobin (Myo; HR = 1.002, 95% CI: 1.000–1.003, p = 0.010), and B-type natriuretic peptide (BNP; HR = 1.003, 95% CI: 1.001–1.006, p = 0.007) as independent predictors. The combined model showed better predictive performance than the clinical-radiological model alone (C-index: 0.791 vs. 0.749). The nomogram demonstrated good calibration and clinical utility across a wide risk threshold range. Conclusion: Myo and BNP provide incremental predictive value for VTE risk stratification in ICH patients beyond traditional factors. The developed nomogram offers a practical tool for individualized risk assessment, potentially guiding optimized VTE prophylaxis strategies.

BackgroundPostoperative venous thromboembolism (VTE) is the most fatal complication of ovarian cancer and adversely affects prognosis. This study aimed to develop and validate predictive models for VTE risk following ovarian cancer resection using machine learning (ML) techniques and incorporating perioperative clinical and surgical variables.MethodsRetrospective data were collected from 931 patients with ovarian cancer who underwent resection between March 2018 and April 2024 at two tertiary hospitals. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was employed to identify critical predictors of VTE and seven ML models, including Logistic Regression (LR), Decision Tree (DT), Extreme Gradient Boosting Machine (XGBoost), Random Forest (RF), Support Vector Machine (SVM), Naïve Bayes (NB), and Light Gradient Boosting Machine (LGBM) were trained and optimized. Optimal hyperparameters were selected based on a 10-fold cross-validation. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), precision-recall area under the curve (PR-AUC), balanced accuracy, precision, recall, F1 score, and Brier score. The SHapley Additive exPlanation (SHAP) package was used to interpret the optimal models.ResultsThe incidence of postoperative VTE was 10.0% (93/931). Among the models, XGBoost demonstrated superior performance, achieving an AUC of 0.935 (95% CI: 0.902–0.963) and PR-AUC of 0.620 (95% CI: 0.457–0.809), recall of 0.849, F1 score of 0.571, and Brier score of 0.116. SHAP analysis identified residual disease, surgical duration, postoperative D-dimer levels, postoperative chemotherapy, and age as the top five contributors to postoperative VTE risk.ConclusionThe ML-based model, particularly the XGBoost algorithm, effectively predicted the VTE risk in patients with post-resection ovarian cancer. This tool may assist clinicians in early identification of high-risk individuals, thereby enabling personalized thromboprophylaxis and optimizing perioperative management to mitigate VTE-related morbidities.

Venous thromboembolism in multiple myeloma patients treated with BCMA-directed CAR T-cell therapy: A systematic review and meta-analysis

The incidence of venous thromboembolism (VTE) in patients with acute lymphoblastic leukemia (ALL) receiving asparaginase-based induction is high despite primary thromboprophylaxis. Our aim was to derive and externally validate a VTE risk prediction model in patients with ALL receiving asparaginase-based induction. We conducted a multicenter retrospective cohort study of patients (aged ≥18 years) with newly diagnosed ALL receiving asparaginase-based induction. The derivation and external validation cohorts included 306 and 94 patients, respectively. Primary outcome was VTE at any site. A cause-specific Cox proportional hazards model stratified by thromboprophylaxis and center was performed to identify VTE risk factors in the derivation cohort. A risk prediction model for VTE at 30 days was derived using variables with P value < .05 in the multivariable model and was tested in the validation cohort. VTE risk factors on multivariable analysis in the derivation cohort included D-dimer ≥1 μg fibrinogen equivalent unit per mL (hazard ratio [HR], 2.64; 95% confidence interval [CI], 1.07-6.5) and hemoglobin (HR for each 1 g/dL increment, 1.19; 95% CI, 1.06-1.34) at ALL diagnosis. A VTE risk score based on these variables distinguished between a 4% (95% CI, 0.72-12) and 20% (95% CI, 14-27) 30-day cumulative incidence of VTE in the derivation cohort, with similar findings in the validation cohort (area under the curve, 0.56). The negative predictive value for VTE at 30 days was 96% and 93% in the derivation and validation cohorts, respectively, and the positive predictive value was 20% in both. We derived and validated a model using D-dimer and hemoglobin, which stratifies VTE risk in patients with ALL receiving asparaginase-based induction.

Antiangiogenic agents, including vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs), represent an important class of treatments for a range of solid tumors. However, concerns have arisen over potential associations between antiangiogenic agents and thromboembolic events. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared a frequently used VEGFR TKI, cabozantinib, with placebo or usual care. The primary outcome was the risk of any thromboembolism. Secondary outcomes included the risk of venous thromboembolism (VTE), risk of arterial thromboembolism (ATE) and progression-free survival. 14 RCTs were included with a combined total of 4204 patients, of whom 212 (5%) developed thromboembolism. Cabozantinib was associated with a significantly increased risk of any thromboembolism (risk ratio [RR], 2.41; 95% confidence interval [CI], 1.72-3.39) driven by VTE (RR, 3.21; 95% CI, 1.86-5.55) but not ATE (RR, 1.31; 95% CI, 0.76-2.26). To account for between-group differences in time on treatment, progression-free survival-adjusted analyses were conducted, with cabozantinib remaining associated with a significantly increased risk of any thromboembolism (RR, 1.47; 95% CI, 1.02-2.12) and VTE (RR, 1.92; 95% CI, 1.08-3.43) but not ATE (RR, 0.76; 95% CI, 0.41-1.40). In a retrospective single health care system cohort study of 295 patients treated with cabozantinib, a thromboembolism rate of 180 per 1000 patient-years on treatment was observed, with most events occurring in the first 3 months after initiation. Together these data demonstrate that cabozantinib is associated with a significantly increased risk of VTE in patients with cancer.

BackgroundCaprini score, the most commonly used assessment tool for predicting postoperative venous thromboembolism (VTE) risk has shown poor predictive value in colorectal cancer surgery. Recent risk assessment models (RAMs) Sir-Run-Run-Shaw VTE RAM, Risk of Venous Thromboembolism Algorithm (RVTA) score, and Colorectal Cancer - Venous Thromboembolism (CRC-VTE) score, which were specific for colorectal cancer, were developed and had good VTE predictive performance. We sought to externally validate for their generalizability and accuracy in Chinese patients undergoing colorectal cancer surgery.Materials and methodsA retrospective analysis was conducted to predict the 6-month postoperative VTE risk in patients undergoing colorectal cancer surgery from January 2020 to December 2023. Demographic characteristics, clinical data, and 6-month postoperative VTE status of the patients were collected based on Sir-Run-Run-Shaw VTE RAM, RVTA score, CRC-VTE score, and Caprini score. We estimated the four VTE RAMs’ discrimination of 6-month postoperative VTE risk by using the area under the receiver operating characteristic curve (AUROC). Calibration plots, Hosmer-Lemeshow test, and decision curve analysis were also explored to assess the predictive performance of the four VTE RAMs.ResultsA total of 323 patients were included. The median age of our cohort was 66 years (range, 58–73 years), and 182 (56.3%) patients were male. VTE occurred in 68 (21.1%) cases within 6 months after operation, with 5 cases of pulmonary embolism and 63 cases of deep vein thrombosis, of which 45 (66.2%) cases experienced VTE within 4 weeks after operation. Sir-Run-Run-Shaw VTE RAM, RVTA score, CRC-VTE score and Caprini score demonstrated possibly helpful discrimination, with AUCs of 0.691 (95%CI: 0.624–0.758), 0.638 (95%CI: 0.564–0.713), 0.728 (95%CI: 0.663–0.793), and 0.661 (95%CI: 0.596–0.725), respectively. The Hosmer-Lemeshow test indicated a lack of fit for Sir-Run-Run-Shaw VTE RAM, RVTA score, and CRC-VTE score (P < 0.05). Furthermore, decision curve analysis revealed that CRC-VTE score provided greater net benefits than the other VTE RAMs.ConclusionExternal validation of the four VTE RAMs for predicting postoperative VTE in a real-world cohort of colorectal cancer patients showed that CRC-VTE score outperformed the other VTE RAMs. It can help clinicians identify patients with high risk of VTE, thereby facilitating timely prophylactic interventions and close monitoring.

Inflammatory bowel disease (IBD) is associated with elevated postoperative mortality in patients undergoing colorectal cancer (CRC) surgery. Venous thromboembolism (VTE) may partially contribute to this elevated mortality. We investigated VTE risk in patients with and without IBD undergoing their first CRC surgery. We conducted a population-based cohort study using Danish health registries (1996-2021), including all patients undergoing first-time CRC surgery (n = 83,950). Patients with a prior IBD diagnosis were defined as exposed. We calculated the 365-day cumulative risks of VTE and used Cox regression to compute adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). The 30-day VTE risk was 1.5% in patients with IBD and 0.7% in those without IBD (aHR 1.61; 95% CI 0.86-3.01). During this period, the strongest associations were observed among male patients (aHR 2.26; 95% CI 1.06-4.82), patients aged 60-69 years (aHR 4.63; 95% CI 1.88-11.39), those who had received IBD treatment before surgery (aHR 1.95; 95% CI 0.97-3.95), and patients with active disease (aHR 5.29; 95% CI 1.69-16.56). These associations were primarily driven by patients with ulcerative colitis. HRs remained elevated during 91-365 days. Patients with IBD are at elevated risk of VTE after CRC surgery compared with those without IBD. The strongest associations were observed in those who had received IBD treatment before surgery and in those with active disease, particularly patients with ulcerative colitis. These findings emphasize the need for increased VTE awareness and optimizing disease control in patients with high-risk IBD.

Objective Inflammatory bowel disease (IBD) is associated with an increased risk of venous thromboembolism (VTE). We conducted a systematic review and meta-analysis to evaluate the risk of VTE in patients with IBD within 30 days after postdischarge (PD-VTE) after a surgical or non-surgical hospitalisation. Design/method Studies were identified via a systematic search of PubMed, MEDLINE, CENTRAL and Web of Science until 1 June 2024. Eligible studies were multivariable-adjusted or propensity-matched observational cohort studies comparing VTE risk following hospitalisation between IBD and non-IBD cohorts. ORs were calculated using a random-effects model, and subgroup plus sensitivity analyses were conducted to explore heterogeneity. Results Six studies including 148 067 patients with IBD met the inclusion criteria. In the adjusted analysis, patients with IBD had a higher risk of PD-VTE (OR 1.57; 95% CI 1.40 to 1.77) with substantial heterogeneity (I²=67%). Subgroup analysis showed increased risk after surgical hospitalisation (OR 1.34; 95% CI 1.09 to 1.64, I²=35%) and a higher risk following non-surgical hospitalisation (OR 1.70; 95% CI 1.52 to 1.90, I²=0%). Conclusions Patients with IBD are at increased risk of VTE within 30 days after both surgical and non-surgical hospitalisations. These findings support consideration of extended VTE prophylaxis in high-risk hospitalised patients with IBD.

Introduction and objective: Endometriosis is a chronic inflammatory condition affecting approximately 10% of women of reproductive age. Venous thromboembolism (VTE) is a major cause of mortality worldwide. Because the relationship between endometriosis and VTE is not well-defined, we conducted a review of studies that assessed the occurrence of VTE in women with endometriosis. Review methods: A structured PubMed search was conducted to identify studies published between January 2015 and April 2025 assessing the risk of VTE in patients with endometriosis. Seven studies met the inclusion criteria after screening for relevance and exclusion of case reports. Abbreviated description of the state of knowledge: Some large-scale studies suggest an elevated VTE risk in women with endometriosis, particularly in younger individuals, during pregnancy, or when using hormonal therapy. However, results vary due to differences in study design, diagnostic definitions, and confounder adjustment. Pathophysiologically, endometriosis-related inflammation, hormonal influences, and endothelial dysfunction may contribute to a prothrombotic state. Summary: The association between endometriosis and VTE remains unclear; biologically plausible mechanisms and clinical patterns suggest it may be relevant in certain populations. Future research should focus on well-characterized, prospective studies. Clinicians should remain alert to thrombotic risk in women with endometriosis, especially when additional risk factors are present.

BackgroundPituitary surgical intervention remains the preferred treatment for Cushing’s disease (CD) while postoperative venous thromboembolism (VTE) is a significant risk. Whether to prescribe pharmacological thromboprophylaxis presents a clinical dilemma, balancing the benefit of reducing VTE risk with the potential for increasing hemorrhagic events in these patients. Currently, strong evidence and established protocols for routine pharmacological thromboprophylaxis in this population are lacking. Therefore, a randomized, controlled trial is warranted to determine the efficacy and safety of combined pharmacological and mechanical thromboprophylaxis in reducing postoperative VTE risk in patients with CD.MethodsThis investigator-initiated, multi-center, prospective, randomized, open-label trial with blinded outcome assessment aims to evaluate the efficacy and safety of combined pharmacological and mechanical thromboprophylaxis compared to mechanical thromboprophylaxis alone in postoperative patients with CD. A total of 206 patients diagnosed with CD who will be undergoing transsphenoidal surgery will be randomized in a 1:1 ratio to receive either combined pharmacological and mechanical thromboprophylaxis (intervention) or mechanical thromboprophylaxis only (control). The primary outcome is the risk of VTE within 12 weeks following surgery.DiscussionThis trial represents a significant milestone in evaluating the efficacy of combined pharmacological and mechanical prophylaxis in reducing VTE events in postoperative CD patients.Trial registrationClinicalTrials.gov Identifier: NCT04486859, first registered on 22 July 2020.

Few studies have specifically modeled the risk of venous thromboembolism (VTE) for postoperative hepatocellular carcinoma (HCC) patients, although HCC is the third leading cause of cancer death worldwide. This study aimed to develop and validate a nomogram that accurately predicts the risk of VTE in patients after HCC surgery. To develop and validate a nomogram to accurately predict the risk of VTE in postoperative HCC patients by integrating clinical and laboratory risk factors. The model seeks to provide a user-friendly tool for identifying high-risk individuals who may benefit from targeted anticoagulation therapy, thereby improving clinical decision-making and patient outcomes. Data from patients who underwent HCC surgery at Chongqing University Cancer Hospital in China were analyzed. Through univariate and multivariate logistic regression analyses, independent risk factors for VTE were identified and integrated into a nomogram. The predictive performance of the nomogram was assessed via receiver operating characteristic curves, calibration curves, decision curve analysis and other relevant metrics. Of 905 postoperative HCC patients were included in the study. The nomogram incorporated eight independent risk factors for VTE: Karnofsky Performance Scale, base disease, cancer stage (tumor-node-metastasis), chemotherapy, D-dimer concentration, white blood cell count, hemoglobin, and fibrinogen. The C-index for the nomogram model was 0.825 in the training cohort and 0.820 in the validation cohort, indicating good discriminative ability. Calibration plots of the model revealed high concordance between the predicted probabilities and observed outcomes. We developed and validated a novel nomogram that can accurately estimate the risk of VTE in individual postoperative HCC patients. This model can identify high-risk patients who may benefit from targeted anticoagulation therapy.

ObjectiveTo investigate the role of ultrasound spontaneous echo contrast (SEC) in venous thromboembolism (VTE) in patients with severe spontaneous cerebral hemorrhage (ICH) and to construct a clinical prediction model.MethodsA total of 69 critically ill ICH patients admitted to the Department of Critical Care Medicine of Liangjiang Hospital of Chongqing Medical University between January 2022 and March 2024 were included in the study. Datas were collected prospectively, including general information, test data, clinical outcomes, and lower limb vascular ultrasound images within 48 h of admission. The statistical analysis was conducted using SPSS 22.0, and the model was constructed using binary logistic regression analysis. The efficacy of the model was assessed using subject operating (ROC) curves and the Hosmer-Lemeshow goodness-of-fit test.ResultsThe SEC, Albumin and age were identified as independent risk factors for thrombosis in patients with severe ICH. The joint prediction model, constructed based on the indicators, is given by the following equation: Logit(P) = 0.477–0.216 * Albumin + 1.43 * SEC + 0.044 * age. The model demonstrated consistent predictive performance, exhibiting good discrimination (AUC = 0.900) and calibration (Hosmer-Lemeshow χ2 = 5.231, p = 0.733 > 0.05).ConclusionThe ICH-VTE early warning model constructed on the basis of SEC, Albumin and age performs well and helps clinicians to dynamically assess the risk of VTE to determine the timing of anticoagulation, which provides therapeutic ideas to reduce the incidence of VTE and improve the clinical outcome of ICH.

Venous thromboembolism (VTE) is a significant and avoidable complication that may occur after total hip arthroplasty (THA). Various mechanical and chemical prophylactic measures may mitigate this elevated risk of death and functional impairment. Consequently, early prevention of VTE is essential via the identification of related risk factors. A search was performed using the databases of PubMed, ScienceDirect, PEDro, and Cochrane Library to get papers from 2004 to 2024 in accordance with PRISMA guidelines. Only randomized controlled trials (RCTs) published in English that included at least one group undergoing intermittent pneumatic compression (IPC) treatment as a prophylactic intervention after total hip arthroplasty (THA) were included. This systematic review has been registered in PROSPERO. The quality evaluation of the included studies was conducted using the PEDro scale and the Cochrane risk of bias instrument. We selected 12 studies from a total of 733 based on predetermined criteria. A total of 2,352 patients of both genders underwent total hip arthroplasty, comprising 1,294 patients in the experimental group and 1,058 patients in the control group across the included studies. The results indicate that the combination of IPC and pharmaceutical agents was the most effective treatment for reducing VTE risk in patients who underwent THA. IPC therapy is very effective in avoiding VTE, particularly when used in combination with pharmacological therapies after THA surgery. The best ways to lower the risk of VTE are to use both IPC and anticoagulants together. However, IPC alone may lower the risk of VTE compared to not using any prevention at all. In general, IPC is a crucial component of comprehensive VTE prevention strategies in THA.

817: INVESTIGATING 5-YEAR VENOUS THROMBOEMBOLISM RISK IN PATIENTS WITH GASTRIC NEUROENDOCRINE TUMORS: A U.S. COHORT STUDY

Abstract Introduction/Rationale Multiple reports have linked the increased risk of venous thromboembolism (VTE) as a complication in patients with interstitial lung disease (ILD), yet the reports are limited across ILD subtypes. This study aimed to evaluate and compare VTE incidence and associated risk factors between idiopathic ILD and connective tissue disease-associated interstitial lung disease (CTD-ILD) during hospitalization. Methods ILD patients were analyzed using 2016-2020 National Inpatient Sample (NIS) data, distinguishing idiopathic ILD from CTD-ILD. The primary outcome was VTE incidence, including pulmonary thromboembolism (PE) and deep vein thrombosis (DVT), and secondary outcomes included in-hospital mortality, intensive care unit (ICU) admissions, length of stay (LOS), and total hospital charge (THC). Univariate and multivariate logistic regression were used to adjust for common confounders such as sex, age, race, tobacco use, varicose veins, and other comorbidities. Results Among 4,675,914 patients hospitalized with ILD, 82,015 developed VTE. CTD-ILD patients with VTE represented 6.9% of the cohort. The mean age in patients who had a VTE event with CTD-ILD patients was 67.7 years represented by 68.5% females, versus 69.9 years in idiopathic ILD patients with a VTE event, of which 46.9% were females (p &amp;lt; 0.001). In patients with CTD-ILD, the incidence of DVT and PE respectively was 1.79%, and 0.41% compared to 1.47%, and 0.26% in idiopathic ILD patients. CTD-ILD was significantly associated with VTE with an aOR of 1.23, (95% CI [1.16, 1.32], p &amp;lt; 0.001) while adjusting for cofounders. However, the CTD-ILD group showed no significant association with in-hospital mortality (p = 0.06), and ICU admissions were lower in comparison to the idiopathic ILD group (aOR=0.48, 95% CI [0.4, 0.58], p &amp;lt; 0.001) on multivariate analysis. The mean LOS was longer in idiopathic ILD patients with VTE, accounting for 11 days versus 8.4 days for CTD-ILD patients with VTE, and their THC was higher, with 145,292 dollars vs 101,478 dollars. Conclusion Our results highlight the need for tailored VTE prophylaxis strategies and close monitoring for VTE risk in patients with CTD-ILD. Further studies should explore other risk factors for the development of VTE in this population.

Background Earlier studies, mainly prior to the widespread use of advanced therapy and implementation of guidelines for thromboprophylaxis indicate a doubled risk of venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD). Methods Using Swedish healthcare registers, we identified a population-based cohort of patients with incident IBD 2007–2021. Patients were matched by age, sex, calendar year of birth and place of residence with up to 10 reference individuals. The primary outcome was VTE, i.e., pulmonary embolism (PE) and deep vein thrombosis (DVT). Incidence rates (IRs) per 1000 person-years, cumulative incidence and hazard ratios (HRs) were calculated for IBD overall and according to clinical characteristics. The temporal trend of the incidence of VTE by calendar year was presented. Results We followed 55,252 IBD patients and 536,067 reference individuals, for a median of 6.5 years. The incidence of VTE in IBD was 5.03 vs. 2.35 per 1000 person-years among reference individuals, corresponding to a doubled risk of VTE (HR = 2.12; 95% confidence interval [CI] 2.02–2.23). Particularly high risks were seen in the first year of follow-up, and among patients with extensive ulcerative colitis (UC), primary sclerosing cholangitis (PSC), extraintestinal manifestations, perianal disease and hospitalization at diagnosis. The occurrence of VTE in IBD did not decrease across calendar years. Conclusions IBD remains linked to an elevated risk of VTE, particularly with disease characteristics associated with a higher inflammatory burden and higher age. Our findings underscore the importance of continuous vigilance and individual assessment of VTE risk in patients with IBD.

This review explores the medical management of abnormal uterine bleeding (AUB) in women at risk for venous thromboembolism (VTE), with a focus on six key principles to consider when initiating hormonal therapies for this patient population. Case studies are used to illustrate these principles in practice, emphasizing the importance of assessing the patient's thrombotic risk and selecting appropriate therapies to effectively manage AUB while minimizing the risk of VTE. While estrogen and certain high-dose progestins are known to elevate VTE risk, evidence suggests that progestin-only formulations and lower-dose hormonal therapies may not significantly increase this risk, even in vulnerable populations. Antifibrinolytic agents such as tranexamic acid are effective in reducing menstrual blood loss without the risk of thromboembolic complications. There is wide variability in the thrombotic risks associated with the various hormonal and nonhormonal therapies available for managing AUB. A thorough evaluation of a patient's VTE risk factors and preferences is essential for effectively managing AUB in women at risk for thrombotic events.