Post-traumatic care is evolving from a reactive, protocol-driven paradigm to a predictive, personalized approach. This review examines how artificial intelligence and machine learning are redefining postoperative management by predicting complications before they manifest. Recent literature (2023-2025) highlights three major advances: (a) the validation of gradient boosting algorithms (e.g. Extreme Gradient Boosting) that significantly outperform traditional scoring systems for predicting trauma-induced coagulopathy; (b) the development of interpretable, phenotype-specific models for venous thromboembolism risk stratification, particularly in traumatic brain injury; and (c) the emergence of real-time sepsis prediction tools that account for the sterile inflammation inherent to trauma. However, a recurring limitation in current research is the reliance on retrospective datasets and single-center validations, underscoring the critical need for rigorous external validation across diverse patient populations before widespread clinical adoption. Artificial intelligence is not merely a monitoring tool but a driver of precision medicine in trauma. By leveraging diverse modalities, from computer vision in radiology to natural language processing in electronic health records, clinicians can now anticipate adverse events. To bridge the gap between algorithm and bedside, future efforts must focus on overcoming significant implementation barriers, such as data interoperability, and ensuring model generalizability.

The American Society of Hematology (ASH) recommends assessing venous thromboembolism (VTE) and major bleeding risk to optimize pharmacological VTE prophylaxis for medical inpatients. However, the clinical utility of model-guided approaches remains unknown. Our objective was to estimate differences in VTE and major bleeding rates and efficiency with prophylaxis guided by risk models versus clinician judgment. Patients were adults admitted to one of 10 Cleveland Clinic hospitals between December 2017 and January 2020. We compared real-world practice with hypothetical prophylaxis recommended by model-based strategies, including widely used risk scores (Padua & IMPROVE) and locally derived Cleveland Clinic risk prediction models. For each strategy, we quantified the prophylaxis rate, VTE and major bleeding rates, and the incremental number-needed-to-treat (NNT) to prevent one event (VTE or bleeding). Clinicians prescribed prophylaxis to 62% of patients whereas model-based strategies recommended prophylaxis for 17%-87%. Model-guided prophylaxis produced more VTEs and fewer major bleeds than real-world practice, but total events varied among strategies. Overall, per 1000 patients, model-based strategies produced 14.0-16.1 events compared with 14.3 for real-world practice. The Padua & IMPROVE strategy minimized prophylaxis but caused the most total events. The most efficient model-based strategy recommended prophylaxis to 28% of patients with an incremental NNT (relative to no prophylaxis) of 80. Compared to real-world practice, it reduced prophylaxis by 55% and total events by 0.14%. Clinicians often prescribed inappropriate prophylaxis, highlighting the need for decision support. Model-guided prophylaxis maximized efficiency by reducing prophylaxis relative to real-world practice without increasing event rates.

Venous thromboembolic (VTE) complications contribute substantially to perioperative morbidity and mortality. The decision for mechanical and/or chemo-prophylaxis is currently based on VTE risk assessment models since conventional laboratory assays of coagulation usually fail to detect changes indicating hypercoagulability. Rotational thromboelastometry is a novel assay of coagulation, that it could potentially be used in objectively selecting patients at risk for VTE, who should indisputably undergo prophylaxis. We evaluated the association of conventional and novel assays of coagulation and VTE risk. VTE risk was preoperatively assessed in 45 patients scheduled for endoscopic, open and laparoscopic urologic surgery, including transurethral resection of prostate, transurethral resection of bladder tumor, endoscopic vesical or ureteral stone lithotripsy, open prostatectomy, open cystectomy and urinary diversion, open or laparoscopic radical or partial nephrectomy, between March 2021 and October 2022, using three different risk assessment models (RAMs): the European Association of Urology (EAU) RAM, the American Urological Association (AUA) RAM, and the Caprini model. Patients under antiplatelet or anticoagulation agents were excluded. Patients' coagulation profile was determined by measuring PT, fibrinogen, aPTT, and rotational thromboelastometry analysis. For rotational thromboelastometry analysis, extrinsic rotational thromboelastometry and fibrinogen rotational thromboelastometry were examined in every patient. Statistical analysis was performed with ANOVA test and χ2 test. Mean values of all rotational thromboelastometry variables did not vary significantly among different EAU VTE categories. In extrinsic rotational thromboelastometry assessment, a significant difference was observed in the mean values of the Clotting time (CT) between the different risk groups based on AUA RAM. In the comparison between the risk groups defined based on the Caprini score, statistically significant differences were observed in the extrinsic rotational thromboelastometry clot formation time (CFT). In fibrinogen rotational thromboelastometry analysis, significant differences were identified in the clot amplitude after five minutes (A5) and maximum clot firmness (MCF) indices between the AUA risk groups, along with a significant difference in the mean clot formation rate (CFR) value between the risk groups defined based on the Caprini score. Rotational thromboelastometry can provide a detailed evaluation of the hemostatic status in patients undergoing urologic surgery that can be used as an adjunct to the VTE risk assessment models and thus, help to offer prophylaxis on a rather personalized basis. Future studies should assess the utility of thromboelastometry in identifying patients at high risk for VTE after major urological procedures.

Epidemiological and experimental studies suggest cocoa flavanols and multivitamin-multimineral (MVM) supplements may confer arterial vascular benefits. However, their effects on clinical venous thromboembolic events have been infrequently examined. To evaluate whether cocoa extract (CE) or MVM supplementation reduces the risk of venous thromboembolism (VTE) among older adults. We conducted an ancillary study analysis of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a completed randomized, double-blind, placebo-controlled, 2-by-2 factorial trial of CE and MVM supplementation for the prevention of cardiovascular disease and cancer among 21,442 older US adults. Our primary outcome was self-reported incident VTE, defined as the first reported deep vein thrombosis (DVT) or pulmonary embolism (PE) event after randomization; secondary outcomes were the individual components. Over a median follow-up of 3.5 years, 379 participants reported an incident VTE event (including 277 DVT and 165 PE). In intention-to-treat analyses, neither CE (HR: 0.88; 95% CI: 0.72, 1.08) nor MVM (HR: 0.89; 95% CI: 0.73, 1.09) significantly reduced VTE risk, with similar findings for DVT and PE. Exploratory latency and per-protocol analyses suggested potential patterns of benefit that merit further evaluation. In this large trial of older adults, neither CE nor MVM supplementation significantly reduced the risk of VTE or its component parts in intention-to-treat analyses. Additional research may help clarify whether these supplements influence VTE risk in other contexts or populations.

With the availability of multiple classes of advanced therapies for the treatment of Crohn disease (CD), understanding the comparative safety of different therapies can inform treatment positioning. To compare the risk of serious infections, venous thromboembolism (VTE), and major adverse cardiovascular events (MACE) with different advanced therapies in patients with CD. This retrospective comparative effectiveness research study was conducted between January 1, 2016, and December 31, 2022, with a mean (SD) follow-up of 26.9 (2.4) months until July 1, 2024. Using an administrative claims database (OptumLabs Data Warehouse), commercially insured patients with CD, who initiated treatment with tumor necrosis factor-α (TNF) antagonists, anti-integrin agents (vedolizumab), interleukin (IL)-12/23p40 antagonists (ustekinumab), IL-23p19 antagonists (primarily risankizumab), or Janus kinase inhibitors (upadacitinib) between 2016 and 2022 and had follow-up for at least 1 year before and after treatment initiation, were included. TNF antagonists vs anti-integrin agents (vedolizumab) vs IL-12/23p40 antagonists (ustekinumab) vs IL-23p19 antagonists (risankizumab) vs Janus kinase inhibitors (upadacitinib). The risk of serious infections, VTE, and MACE was compared with various advanced therapies through multinomial propensity score-based inverse probability treatment weighting, with propensity scores estimated through generalized boosted models, accounting for disease characteristics, health care utilization, comorbidities, and prior and concomitant medications, and through competing risk of mortality. Cause-specific hazard ratios (HRs) and 95% CIs for multiple treatment comparisons were calculated. This study included 12 245 patients with CD (mean [SD] age, 46.5 [17.5] years; 6642 females [54.2%]), who were treated with TNF antagonists (n = 5274), vedolizumab (n = 2716), ustekinumab (n = 3544), risankizumab (n = 559), or upadacitinib (n = 152). Serious infection incidence rates ranged from 5.46 (95% CI, 4.86-6.07) to 9.02 (95% CI, 6.38-11.89) per 100 person-years across therapies. After adjusting for confounding variables, there were no statistically significant differences in the risk of serious infections across different agents, including between risankizumab and ustekinumab (HR, 1.14 [95% CI, 0.78-1.67]), risankizumab and TNF antagonists (HR, 1.00 [95% CI, 0.68-1.47]), or ustekinumab and TNF antagonists (HR, 0.88 [95% CI, 0.74-1.04]). The incidence of VTE (incidence rate, 0.90 [95% CI, 0.71-1.10] to 2.33 [95% CI, 1.06-3.82] per 100 person-years) and MACE (0.68 [95% CI, 0.51-0.85] to 1.49 [95% CI, 0.43-2.76] per 100 person-years) was low, without any significant differences across agents. In this comparative effectiveness research study of patients with CD, no significant differences in the risks of serious infections, VTE, or MACE across various advanced therapies were found. These findings support clinical decision-making on choice of advanced therapies for most individual patients with CD to be driven primarily by comparative treatment effectiveness rather than driven by concerns of serious adverse events.

What are the benefits and risks of statins for the primary prevention of venous thromboembolism (VTE)?

Incidence and Risk Factors for Venous Thromboembolism in Hemodynamically Unstable Pelvic Fractures.

To determine the safety and efficacy of ruxolitinib (RUX) and fostamatinib (FOS) compared with standard of care (SOC) in patients requiring hospital admission for the treatment of COVID-19 pneumonia. Adaptive multiarm, multistage, randomised, open-label trial (three arm, two stage). Five hospitals in England between October 2020 and September 2022. Hospitalised patients (≥18 years) with COVID-19 pneumonia defined by a modified WHO COVID-19 severity grade of 3 or 4. Participants were randomly assigned 1:1:1 to receive RUX (10 mg two times per day for 7 days then 5 mg two times per day for 7 days), FOS (150 mg two times per day for 7 days then 100 mg two times per day for 7 days) or SOC. Primary outcome was development of severe COVID-19 pneumonia (modified WHO severity grade≥5) within 14 days of randomisation. Secondary outcomes included mortality, invasive and non-invasive ventilation, venous thromboembolism, duration of hospital stay, readmissions, inflammatory markers and serious adverse events (SAEs). At stage 1, 181 patients were randomised, with 4 assessed as ineligible post randomisation. FOS was stopped early for futility with 16 participants (27.6%, n=58) developing severe COVID-19 pneumonia compared with 15 (25.0%, n=60) in the SOC arm (adjusted odds ratio (aOR) compared with SOC: 1.12; 95% CI 0.49 to 2.58; p=0.608). RUX progressed to stage 2 but the trial was stopped early due to slow recruitment. At the final analysis, 10 participants (16.1%, n=62) developed severe COVID-19 pneumonia in the RUX arm compared with 15 (24.6%, n=61) in the SOC arm (aOR: 0.63; 95% CI 0.25 to 1.57; p=0.161). Four (7.4%) participants in the FOS arm, none in the RUX arm and three (5.5%) in the SOC arm died within 14 days of randomisation. Infections were the most frequently reported SAE and were numerically higher in the FOS (10, 17.2%) and RUX (10, 16.1%) arms compared with SOC (7, 11.5%). Two unexpected serious adverse reactions occurred in the RUX arm only. We found no evidence that FOS was superior to SOC for the treatment of COVID-19 pneumonia in patients requiring hospital admission. Due to early stopping, the trial was underpowered to establish RUX's effect in this population. Further study is needed. NCT04581954; EUDRA-CT: https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-001750-22/GB.

Chronic Venous Disease (CVD) is a common vascular disorder, primarily affecting the lower extremities, with a significantly higher incidence in women. Pregnant women represent a particularly high-risk population for CVD. Early screening and assessment of CVD severity and progression during pregnancy are imperative for preventing Venous Thromboembolism (VTE). Despite its high prevalence, CVD in pregnancy often remains underestimated, frequently being managed by clinicians as a localized and benign condition. However, emerging evidence suggests that CVD may exert broader systemic effects, potentially compromising placental development and fetal well-being through alterations in the maternal-placental-fetal circulation. Nevertheless, the precise correlations between CVD and a spectrum of adverse pregnancy outcomes remain unclear. Also, the standardized management strategies for CVD in pregnancies are yet to be established. This review synthesizes current literature to delineate the present understanding and identify persistent knowledge gaps in this field. Furthermore, it aims to underscore the clinical significance of CVD in pregnancy and to propose pertinent directions for future research, thereby advocating for heightened clinical awareness and more investigative efforts.

Background Fondaparinux sodium, a synthetic pentose sugar, selectively inhibits factor Xa and is mainly used to prevent venous thromboembolism during major lower extremity orthopedic surgeries. It is also utilized for treating unstable angina pectoris and non-ST-segment-elevation myocardial infarction (NSTEMI). Given its extensive clinical application, comprehensive evaluation of its safety profile in clinical practice is essential. Methods This pharmacovigilance investigation systematically evaluated the post-marketing safety profile of fondaparinux sodium by leveraging real-world data from the FDA Adverse Event Reporting System (FAERS) database (Q1 2004 to Q3 2024), where fondaparinux sodium was the primary suspected drug. To further validate the robustness and generalizability of our findings, we cross-referenced the identified signals with data from two external sources: the VigiAccess database (Q2 2003 to Q4 2025) and the Japanese Adverse Drug Event Report (JADER) database (Q2 2007 to Q2 2025). Disproportionality analyses employed the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multiple empirical Bayes Gamma–Poisson shrinker (MGPS). Furthermore, sensitivity analyses were conducted to ensure the robustness of the results. Finally, the optimal parametric model was applied to estimate the temporal risk of adverse events (AEs). Results In the FAERS database, we identified 5,700 fondaparinux sodium-related AE reports, corresponding to 17,061 unique Preferred Terms (PTs). Time-to-onset analysis ( N = 2,220) showed an early-peak profile ( β = 1.2, median: 7 days), with 81.98% of events within 30 days. Disproportionality analysis confirmed positive signals for haemorrhagic complications across all demographics. Subgroup analysis revealed higher bleeding RORs in females, and increased risks of anemia and skin necrosis in the elderly patients(≥ 65 years). Pediatric patients (< 18 years) showed rare but significant hepatotoxicity. Healthcare professionals reported more complex clinical terms, while consumers reported more symptomatic events. Several unbalanced signals, including haematemesis (ROR = 14.52, 95%CI: 11.99–17.58) and skin necrosis (ROR = 27.29, 95%CI: 20.06–37.12) were identified. Sensitivity analyses further confirmed the robustness of these findings, and key signals were cross-referenced with the VigiAccess database and JADER database. The detection of these signals highlights potential safety concerns that warrant further clinical monitoring rather than confirming definitive causality. Conclusion This study serves as a hypothesis-generating inquiry into the real-world safety of fondaparinux sodium. While our findings align with established adverse reaction profiles, they also highlight potential novel signals that warrant further investigation. These insights provide valuable reference points for clinical monitoring, particularly in special populations, though further epidemiological studies are needed to verify causality.

Background: The European Society of Cardiology (ESC) published the first guidelines on cardio-oncology in 2022. Implementing the 272 proposed recommendations into everyday clinical practice has become a mandatory challenge for countries belonging to the ESC community. Methods: The study aimed to assess cardio-oncology knowledge and the degree of implementation of ESC guidelines among cardiologists registered with the Heart Failure Association of the Polish Cardiac Society and oncologists from the Polish Society of Clinical Oncology. Physicians were invited via email and voluntarily chose to participate by completing a 20-question questionnaire. Results: Among the 104 respondents, half (50%) were cardiologists, and the majority (80%) had more than ten years of clinical experience. A total of 38.8% of specialists practiced outpatient medicine, while 41.7% worked in academic centres. The majority (58.3%) consult fewer than ten cardio-oncology patients per week, with less than 8% of specialists having the greatest experience (>25 consultations per week). Most physicians were familiar with the ESC guidelines on cardio-oncology. Cardiologists more frequently indicated heart failure as the main problem in cancer patients (OR = 5.82; 95% CI: 2.08–16.22; p = 0.0007), ordered echocardiography and ECG together with cardiovascular risk factors control (OR = 4.01; 95% CI: 1.74–9.25; p = 0.001) during long-term follow-up, chose angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACEi/ARB) combined with calcium channel blocker (CCB) for treating hypertension (OR = 3.9; 95% CI: 1.56–9.75; p = 0.003), and rarely monitored lipid profile based on the type of cancer therapy (OR = 0.09; 95% CI: 0.03–0.26; p = 0.000009). Oncologists more often observed cardiovascular issues in lung cancer (OR = 3.78; 95% CI: 1.58–9.05; p = 0.002), recognized venous thromboembolism as the most common problem in cardio-oncology (OR = 6.52; 95% CI: 2.7–15.73; p = 0.00002), opted for ACEI/ARB monotherapy in the management of high blood pressure (OR = 11.76; 95% CI: 2.49–55.54; p = 0.002), and significantly more often chose low-molecular-weight heparin in the treatment of asymptomatic incidental pulmonary embolism (OR = 5.93; 95% CI: 2.47–14.24; p = 0.00006). Conclusions: The understanding of cardio-oncology varies significantly between cardiologists and oncologists. Although the survey was conducted only in one country (Poland), its results may serve as a reference point for structural reforms with building implementation strategies of ESC guidelines in daily practice in other countries.

Tranexamic acid (TXA) is widely used in surgery to reduce perioperative bleeding, but concerns persist regarding its potential thromboembolic risks. This study evaluates the association between intraoperative intravenous (IV) TXA use and 90-day postoperative venous thromboembolism (VTE) risk in patients undergoing plastic and reconstructive surgery of the head and neck. We conducted a retrospective cohort study using the Fortuna database, a national administrative claims dataset with over 200 million patients. Adult patients undergoing plastic and reconstructive surgery between 2010 and 2024 were identified using CPT codes, and whether they received IV TXA on the index day of procedure was determined. The primary outcome was VTE diagnosis within 90 days postoperatively. Use of enoxaparin or heparin was also documented. High-dimensional propensity score matching with inverse probability of treatment weighting (IPTW) was used to adjust for baseline demographics, comorbidities, medication exposures, and healthcare utilization. Logistic regression was used to evaluate the association between treatment and the binary outcome. A total of 1,011 patients received IV TXA and 157,959 did not. After propensity score matching, the two groups were well-balanced. The incidence of VTE was 0.2% in the TXA group, and 0.28% in the non-TXA group. Weighted logistic regression demonstrated no statistically significant difference in VTE risk (OR 0.62, 95% CI: 0.13-3.04, p = 0.55). IV TXA use was not associated with increased postoperative VTE risk in plastic and reconstructive surgery of the head and neck, supporting its continued use as a safe hemostatic adjunct in this patient population.

Recently, increasing studies have reported that Parkinson's disease (PD) may experience an increased incidence of venous thromboembolic events and complications for patients who undergo surgery. We aimed to explore the actual prevalence and risk factors of venous thromboembolism (VTE) for patients with PD as well as its influence on the operative outcomes. We searched PubMed, Embase, and Cochrane library up to 1 May 2025 for observational studies exploring the risk factors of venous thromboembolic events or comparing the frequency of venous thromboembolic events and complications in PD and non-PD patients. The primary outcomes were the risk factors for and incidence of venous thromboembolic events in patients with PD. The secondary outcome was comparing the complications or adverse events between PD and non-PD patients. Two reviewers screened the titles and abstracts of searched records for qualified reports according to the including and excluding criteria and extracted the data independently. Finally, we totally identified 17 observational studies involving 760380 patients for the present analysis. Our pooled results indicated that when compared to patients without PD, patients with PD had significantly higher incidence of venous thromboembolic events, including VTE (OR 1.35, 95% CI 1.11-1.65), deep vein thrombosis (DVT; OR 1.56, 95% CI 1.24-1.96) and pulmonary embolism (PE; OR 1.54, 95% CI 1.20-1.96), respectively. In addition, when comparing DVT (+) and DVT (-) in patients with PD, female patients with PD had a higher frequency of DVT (OR 2.45, 95% CI 1.47-4.06), patients with lower Barthel index [mean difference (MD) -11.5, 95% CI -20.85-2.15] and those with smaller abdominal circumference (MD -7.13 cm, 95% CI -9.99 to -4.26), respectively. When compared to PD patients without DVT, PD patients with DVT had significantly higher average real variability of systolic blood pressure (MD 3.2mmHg, 95% CI 0.75-5.65), lower heart rate at admission (MD -3.32bpm, 95% CI -6.58 to -0.06), higher D-dimer (MD 2.14µg/mL, 95% CI 1.20-3.08), and longer duration of illness (MD 22.68months, 95% CI 6.77-38.58), respectively. Our pooled analysis also indicated that PD increased complications and adverse events of patients receiving operation. Patients with PD were more prone to venous thromboembolic events and had an increased incidence of intra- and post-operative complications. Though several risk factors of DVT were identified for Parkinson's patients, they need further demonstration with specific researches in the future. Greater vigilance should be exercised to make an informed decision regarding patient care and preferred healthcare setup for patients with PD.

Cancer-associated venous thromboembolism (CA-VTE) is a leading, severe, and potentially life-threatening complication in patients with malignancy. Low-molecular-weight heparin has historically been the standard of care; however, direct oral anticoagulants, particularly direct factor Xa inhibitors, have emerged as effective alternatives. These agents offer the convenience of oral administration, predictable pharmacokinetics, elimination of routine laboratory monitoring, and improved adherence. Despite the expanding role of direct oral anticoagulants in CA-VTE management, concerns regarding bleeding risk-particularly in patients with gastrointestinal and genitourinary malignancies-remain central to clinical decision-making. In this narrative review, we evaluate the efficacy, safety, and clinical applicability of apixaban for the treatment and prophylaxis of CA-VTE. Current evidence from randomized controlled trials, including CARAVAGGIO and AMPLIFY, demonstrates that apixaban has noninferior efficacy compared with low-molecular-weight heparin and conventional anticoagulation strategies, with comparable or lower rates of recurrent venous thromboembolism. In addition, apixaban appears to have a favorable safety profile, with no statistically significant increase in major bleeding in selected cancer populations, including those without active gastrointestinal lesions. Apixaban's pharmacokinetic properties, including limited renal clearance and stable drug exposure, further enhance its clinical utility in oncologic populations. However, evidence supporting apixaban use across all cancer subtypes remains limited and heterogeneous, highlighting the need for additional comparative and real-world studies.

The Association between Distressed Community Index and Failure to Rescue after Cardiac Surgery among Medicare Beneficiaries.

Optimal timing of anticoagulation therapy for venous thromboembolism prevention after intracranial hemorrhage.

Factors associated with venous thromboembolism in hospitalized traumatic brain injury patients with external ventricular drains: Retrospective cohort study.

Prior Venous Thromboembolism Increases Risk of 90-Day Deep Vein Thrombosis, Pulmonary Embolism, and 2-Year Periprosthetic Joint Infection After Total Knee Arthroplasty.

Venous thromboembolism (VTE) has a high incidence among patients with cholangiocarcinoma (CCA). However, appropriate risk assessment models (RAMs) for CCA are limited. This study aimed to develop a RAM for predicting VTE in patients with CCA. We conducted a retrospective study at a single university-based hospital in Thailand. We included consecutive patients who were newly diagnosed with CCA between January 2018 and December 2022. A total of 694 CCA patients were included in the study. A 12-month follow-up period, 91 patients (13.11%) developed VTE. The logistic regression analysis initially considered 18 potential clinical predictors, and after using backward elimination, five key predictors were identified: ECOG score ≥ 2, intrahepatic CCA, stage IV CCA, total bilirubin ≤ 13 mg/dL, and CA19-9 > 1600 U/mL. These predictors formed the basis of the scoring system. The resulting RAM achieved an area under the receiver operating characteristic curve (AuROC) of 0.70 (95% confidence interval [CI] 0.64-0.75), indicating acceptable discrimination. The scoring system, ranging from 0 to 6, was categorized into three groups. For the validation group, the AuROC curve was 0.68 (95% CI: 0.63-0.73). In addition, the model demonstrated consistently high NPV across all risk categories, indicating strong performance in ruling out VTE. Therefore, this score is most useful for identifying non-high-risk patients. In conclusion, a RAM for VTE in CCA was developed by incorporating five critical risk factors. This model may assist clinicians in identifying individuals for risk of VTE. External validation is warranted to confirm its generalizability.

Thrombin generation and thrombin dynamics are associated with recurrent venous thromboembolism after anticoagulation withdrawal.