Epidemiological Characteristics of Venous Thromboembolism Among Inpatients at the People's Hospital of Xizang Autonomous Region: A Cross-Sectional Study from the Perspective of Chronic Disease Pharmaceutical Clinic in a High-Altitude Region

To investigate the epidemiological characteristics of venous thromboembolism (VTE) among inpatients at the People's Hospital of Xizang Autonomous Region, and to provide data support for the establishment of a standardized risk screening and pharmaceutical care system in the plateau chronic disease pharmaceutical clinic.

This study was a retrospective cross-sectional survey. Patients discharged with a diagnosis of VTE from the People's Hospital of Xizang Autonomous Region between January 2019 and December 2024 were selected. General data, clinical outcomes, and anticoagulation regimens were collected. The Mann-Kendall trend test was used to analyze the temporal trend of VTE prevalence, and multivariate Logistic regression was used to analyze the influencing factors of VTE occurrence.

A total of 939 VTE patients were included, comprising 492 females (52.40%) and 447 males (47.60%), with a mean age of (54.87±20.10) years. There were 339 elderly patients aged ≥65 years and 600 patients aged < 65 years. In terms of treatment outcomes, the clinical improvement (improvement) rate was 79.02%, and the cure rate was 10.76%. Among thrombus types, pulmonary embolism (PE) accounted for the highest proportion (58.79%), with low-risk PE being the main subtype (35.50%). The main comorbidity among VTE patients was hypertension (39.94%), followed by acute myocardial infarction or ischemic stroke (11.40%). The prevalence of VTE increased from 0.62% in 2019 to 1.07% in 2024. The Mann-Kendall trend test showed a Kendall's Tau coefficient of 0.733 (P=0.028), indicating a significant upward trend in the proportion of VTE patients at the hospital from 2019 to 2024. Univariate Logistic regression analysis showed that age ≥65 years, hypertension, overweight/obesity, diabetes, tumor, history of cardiovascular events, elevated D-dimer, decreased estimated glomerular filtration rate (eGFR), high hemoglobin, and inpatient department were significantly associated with the occurrence of VTE (all P < 0.05). Multivariate Logistic regression analysis showed that after adjusting for sex, ethnicity, inpatient department, D-dimer, eGFR, tumor, diabetes, history of cardiovascular events, history of VTE, and recent surgical history, hypertension (aOR=2.30, 95% CI: 1.80-2.94, P < 0.001), overweight/obesity (aOR=1.78, 95% CI: 1.34-2.36, P < 0.001), and age ≥65 years (aOR=1.28, 95% CI: 1.01-1.62, P=0.041) were significantly positively correlated with VTE, while high hemoglobin was significantly negatively correlated with VTE (aOR=0.75, 95% CI: 0.59-0.95, P=0.018). Subgroup analysis showed that among internal medicine patients, hypertension (aOR=2.51, 95% CI: 1.89-3.33, P < 0.001) and overweight/obesity (aOR=1.92, 95% CI: 1.40-2.63, P < 0.001) were significantly positively correlated with VTE; while among surgical patients, only hypertension was significantly positively correlated with VTE (aOR=1.92, 95% CI: 1.20-3.07, P=0.007). Age stratification results showed that among patients aged < 65 years, overweight/obesity was significantly positively correlated with VTE (aOR=2.05, 95% CI: 1.48-2.84, P < 0.001); while among patients aged ≥65 years, overweight/obesity was not significantly associated with VTE (aOR=1.41, 95% CI: 0.94-2.12, P=0.098). Discharge anticoagulation was mainly rivaroxaban monotherapy (43.56%), and 33.33% of patients were discharged without anticoagulant medication.

The prevalence of VTE at the People's Hospital of Xizang Autonomous Region is on the rise. The key risk population consists of chronic disease patients with hypertension and obesity. It is necessary to further strengthen early identification of VTE, management of comorbidities, and medication monitoring for chronic disease patients, so as to improve the comprehensive management of VTE in plateau areas.