Risk factors of venous thromboembolism in ICU patients: a systematic review and meta-analysis.
Xiaoli Yang, Xiaoli Zhou, Yuehong Qiu
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In 30 seconds
This systematic review and meta-analysis examined factors associated with venous thromboembolism (VTE) among patients admitted to intensive care units. Of 2465 studies identified, 30 were included in pooled analyses. Central venous catheterization, invasive mechanical ventilation, older age, longer ICU stay, malignancy, elevated D-dimer, and prior VTE were associated with VTE. The largest reported pooled association was for length of ICU stay (OR = 4.24, 95% CI: 1.43-12.57), although heterogeneity was high (I 2 = 98%). Evidence quality was moderate for mechanical ventilation, low for catheterization and D-dimer, and very low for the other factors.
Key findings
- Central venous catheterization was associated with VTE (OR = 2.67, 95% CI: 1.67-4.28; I 2 = 28%); evidence quality was low.
- Invasive mechanical ventilation was associated with VTE (OR = 2.08, 95% CI: 1.46-2.96; I 2 = 0%); evidence quality was moderate.
- Longer ICU stay had the largest pooled association (OR = 4.24, 95% CI: 1.43-12.57), with high heterogeneity (I 2 = 98%) and very low-quality evidence.
- Elevated D-dimer was associated with VTE (OR = 2.46, 95% CI: 1.37-4.40; I 2 = 34%); evidence quality was low.
Why it matters
VTE risk in ICU patients was associated with several clinical and patient factors, but the strength and certainty of evidence varied. The findings highlight potential inputs for risk assessment and patient stratification, while the substantial heterogeneity for some factors and very low evidence quality for most associations warrant caution in interpreting pooled estimates.
What to keep in mind
Evidence quality was low or very low for most factors. Heterogeneity was substantial for length of ICU stay (I 2 = 98%) and advanced age (I 2 = 86%).