Journal of vascular surgery. Venous and lymphatic disorders最新文献

英文中文

Impact of an automated, electronic medical record-integrated inferior vena cava filter tracking system on retrieval rates 自动化电子病历集成下腔静脉过滤器跟踪系统对检索率的影响。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-28 DOI: 10.1016/j.jvsv.2025.102351

Kathy L. Chan MD , Paulina Sun MD , Sudhir Rajan MD , Gabriel Howles-Banerji MD, PhD , Chi-Mei Liu PhD, MBA , Marc Flagg BA , Dongbin Todd BS , Francis Bolanos BSIE , Stephen L. Wang MD

Objective

The aim of this study was to evaluate the effects of an automated, electronic medical record (EMR)-integrated inferior vena cava (IVC) filter tracking system on retrieval rates across a large United States health care system.

Methods

A new, automated EMR-integrated IVC filter tracking system including individual filter plans, dwell time, and anticoagulation status was established across a United States health care system with 22 medical facilities. IVC filter utilization, rates of attempted retrieval, and mean dwell time were retrospectively analyzed between Januaray 2019 and January 2020.

Results

During the study period, filter use was 8.7 per 100,000 members, with 382 IVC filters placed. In statistical comparison to our 2016 study, implementation of this EMR-integrated tracking system increased regional attempted filter retrieval rates by 23.2% (38.9% to 62.1%; P < .001,

χ

²) compared with a pretracking system of 427 patients with IVC filters deployed between December 2011 and January 2013. Compared with a web-based tracking system with physician education (347 IVC filters deployed from February 2013 to May 2014), implementation of this EMR-integrated tracking system increased regional attempted IVC filter retrieval rates by 8.1% (54% to 62.1%; P = .065,

χ

²). Both tracking systems were deployed within the same multifacility regional patient population. In further subanalysis of the EMR-integrated tracking system, among 335 retrievable devices placed, 209 were eligible for retrieval. Of 209 eligible retrieval filters, 169 had attempted retrieval (80.9%) with 165 successfully retrieved (78.9%).

Conclusions

Implementation of an EMR-integrated IVC filter tracking system was associated with increased eligible IVC filter retrieval rates across a large United States health care region to 80.9%, comparable to published rates at single facility centers with dedicated tracking programs. Similar results can be expected in other institutions and health care organizations since this tracking program was created within a widely used EMR.

目的：评估自动化电子病历（EMR）集成下腔静脉（IVC）过滤器跟踪系统对美国大型医疗保健系统检索率的影响。方法：在美国22家医疗机构的医疗保健系统中建立了一个新的自动化emr集成IVC过滤器跟踪系统，包括个人过滤器计划，停留时间和抗凝状态。回顾性分析2019年1月至2020年1月期间IVC过滤器利用率、尝试检索率和平均停留时间。结果：在研究期间，过滤器的使用率为每10万成员8.7个，放置了382个IVC过滤器。与我们2016年的研究进行统计比较，与2011年12月至2013年1月期间部署的427名IVC过滤器患者的预跟踪系统相比，该emr集成跟踪系统的实施使区域尝试过滤器检索率提高了23.2%（38.9%至62.1%;p 2）。与医生教育的基于网络的跟踪系统（2013年2月至2014年5月部署了347个IVC过滤器）相比，该emr集成跟踪系统的实施使区域尝试IVC过滤器检索率提高了8.1%（54%至62.1%;p = 0.065, χ2）。这两种跟踪系统都部署在同一多设施区域患者群体中。在emr集成跟踪系统的进一步子分析中，在放置的335个可检索设备中，209个符合检索条件。在209个符合条件的检索过滤器中，169个尝试检索（80.9%），165个成功检索（78.9%）。结论：在美国大型医疗保健地区，实施emr集成的IVC过滤器跟踪系统可将合格的IVC过滤器检索率提高到80.9%，与具有专用跟踪程序的单一设施中心公布的比率相当。由于该跟踪程序是在广泛使用的电子病历中创建的，因此在其他机构和医疗保健组织中也可以预期类似的结果。

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引用次数: 0

A synergistic multimodality treatment approach to address the key drivers of wound chronicity 一种协同的多模式治疗方法来解决伤口慢性的关键驱动因素。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-23 DOI: 10.1016/j.jvsv.2025.102348

Joann M. Lohr MD , Joseph D. Raffetto MD , David J. Dexter MD , Matthew J. Regulski DPM , Michael E. Edmonds MD , Kathleen J. Ozsvath MD , Melodie M. Blakely DPT

Background

Chronic wounds remain a major clinical and economic burden, affecting millions worldwide. Despite advances in wound care, many wounds fail to heal due to persistent tissue hypoxia, unresolved inflammation, lymphatic dysfunction, edema, and ischemia-reperfusion injury. These interrelated mechanisms are further compounded by comorbidities such as obesity, diabetes, and vascular disease, highlighting the need for therapeutic approaches that address multiple barriers to repair simultaneously.

Methods

We review the pathophysiological drivers of wound chronicity—including the inflammation/edema/hypoxia cycle, endothelial dysfunction, and impaired lymphatic clearance—and summarize evidence on the roles of oxygen, nitric oxide, redox signaling, mechanotransduction, and specialized pro-resolving lipid mediators in tissue repair. We then evaluate two complementary, noninvasive interventions: topical oxygen therapy, which directly elevates wound tissue oxygen tension to support oxidative burst, angiogenesis, collagen synthesis, and specialized pro-resolving lipid mediator biosynthesis; and intermittent compression, which enhances lymphatic drainage, reduces edema, normalizes capillary gradients, and activates mechanosensitive repair pathways in endothelial cells, macrophages, fibroblasts, and keratinocytes.

Results

Chronic wound pathophysiology involves overlapping mechanisms of hypoxia, inflammation, edema, endothelial dysfunction, and reperfusion injury. Both topical oxygen therapy and intermittent compression independently improve oxygen delivery, perfusion, inflammation resolution, and tissue remodeling. When combined as intermittent topical oxygen therapy (ITOT), these modalities exert synergistic effects, amplifying oxygen bioavailability and potentiating anti-inflammatory, angiogenic, and reparative signaling. Clinical studies demonstrate that ITOT significantly increases healing rates, reduces healing time, lowers recurrence, and decreases hospitalizations and amputations in chronic wounds. Cost-effectiveness analyses further indicate improved quality-adjusted life years and reduced long-term expenditures.

Conclusions

Chronic wounds persist due to a self-sustaining cycle of hypoxia, edema, and inflammation. By integrating oxygen delivery with cyclical compression, ITOT directly addresses the multifactorial barriers to repair, promoting durable healing and reducing complications. This multi-modality approach represents a promising therapeutic advance in the management of refractory lower extremity wounds, with broad implications for improving outcomes and quality of life and reducing health care costs.

背景：慢性伤口仍然是一个主要的临床和经济负担，影响着全世界数百万人。尽管伤口护理取得了进步，但由于持续的组织缺氧、未解决的炎症、淋巴功能障碍、水肿和缺血再灌注损伤，许多伤口无法愈合。这些相互关联的机制因肥胖、糖尿病和血管疾病等合并症而进一步复杂化，突出表明需要同时解决多种障碍进行修复的治疗方法。方法和机制原理：我们回顾了慢性伤口慢性的病理生理驱动因素，包括炎症/水肿/缺氧循环、内皮功能障碍和淋巴清除受损，并总结了氧、一氧化氮、氧化还原信号、机械转导和专门的促溶解脂质介质（SPMs）在组织修复中的重要作用的证据。然后，我们评估了两种互补的非侵入性干预措施：局部氧疗（TOT），直接提高伤口组织氧张力以支持氧化破裂、血管生成、胶原合成和SPM生物合成；间歇性压缩（IC），增强淋巴引流，减少水肿，使毛细血管梯度正常化，并激活内皮细胞、巨噬细胞、成纤维细胞和角化细胞的机械敏感修复途径。结果：慢性伤口病理生理是缺氧、炎症、水肿、内皮功能障碍和再灌注影响组织的综合，不同病因的机制有重叠。TOT和IC都能独立改善氧输送、灌注、炎症消退和组织重塑。当与间歇局部氧治疗（ITOT）联合使用时，这些方式发挥协同效应，扩大氧的生物利用度，增强抗炎、血管生成和修复信号。临床研究表明，ITOT可显著提高慢性伤口的治愈率，缩短愈合时间，降低复发，减少住院和截肢。成本效益分析进一步表明，质量调整寿命年（QALYs）得到改善，长期支出减少。结论：慢性伤口持续存在是由于缺氧、水肿和炎症的自我维持循环。通过将氧气输送与周期性压缩相结合，ITOT直接解决了修复的多因素障碍，促进了持久的愈合并减少了并发症。这种多模式的方法代表了治疗难治性下肢伤口的一个有希望的进步，对改善预后和生活质量以及降低医疗成本具有广泛的意义。

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引用次数: 0

Renal angiomyolipoma with inferior vena cava/pulmonary thrombi 肾性AML伴静脉血栓/肺血栓。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-23 DOI: 10.1016/j.jvsv.2025.102349

Tianyu Li MD, Yaru Zhu MD, Siyuan Lu MD, Jing Ye MD

引用次数: 0

General and disease-specific quality-of-life improvement following superficial venous insufficiency treatment 浅静脉功能不全治疗后的一般和疾病特异性生活质量改善。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-22 DOI: 10.1016/j.jvsv.2025.102347

Katherine Cappellano BA , Maysie Calzon BS , Sophia Weldon BS , Esaan Azizi BS , Jin-Ju Lee MPH , Shravani Inampudi BS , John Blebea MD, MBA , Christopher Pittman MD, FAVLS, FACR, FACP (Hon)

Objective

Most of the publications on the treatment of superficial venous insufficiency (SVI) have focused on technical and anatomic success. There are relatively few studies assessing patient-reported outcomes (PROs) after SVI treatment. However, patients and payers are increasingly interested in such outcomes in addition to technical success. We examined PROs after treatment with endovenous radiofrequency thermal ablation (RFA) and ultrasound-guided foam sclerotherapy (UGFS) for patients with SVI.

Methods

A retrospective chart review was performed on 545 consecutive patients with SVI treated between 2019 and 2024. Data on patient demographics, risk factors, Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification, Venous Clinical Severity Score (VCSS), and PROs were collected. The cohort was 395 female (73%) and 150 male (28%), with a median age of 62 years (mean 60 ± 14 years) and a median body mass index of 27 kg/m² (mean 28 ± 7 kg/m²). Most patients were White (n = 459, 84%), with 19 (4%) Black or African American, 7 (1%) Asian, and 39 (7%) other race; 21 (4%) declined to disclose. Prior venous disease was present in 382 patients (70%), whereas 163 (30%) had no history of venous disease. Patients completed two PROs, HASTI (Heaviness, Achiness, Swelling, Throbbing, Itching) and SF-6D (Short Form-6 Dimensions), before and after receiving treatment with RFA followed by UGFS. Data were analyzed using descriptive statistics and paired t tests to compare pre- and post-treatment outcomes.

Results

Most patients were women (72%), with an average age of 60 ± 14 years and an average body mass index of 28 ± 7. The average duration of symptoms before treatment was greater than 1 year, and the most common presenting symptoms included aches/pains, heaviness/tiredness, and cramping. Prior pregnancy was the most prominent risk factor for SVI, observed in 66% of female patients. All measures of HASTI and SF-6D showed improvements in symptom scores. VCSS also improved significantly, from 6.0 ± 2.9 to 3.9 ± 2.6 (P < .001).

Conclusions

Treatment of SVI patients with RFA followed by UGFS significantly improves both disease-specific (HASTI) and general (SF-6D) quality-of-life measures in addition to a decrease in VCSS.

目的：大多数关于治疗浅静脉功能不全（SVI）的出版物都集中在技术和解剖上的成功。评估SVI治疗后患者报告的结果（PROs）的研究相对较少。然而，除了技术上的成功之外，患者和付款人对这些结果越来越感兴趣。我们对SVI患者进行静脉内射频热消融（RFA）和超声引导泡沫硬化治疗（UGFS）后的PROs进行了检测。方法：对2019年至2024年连续545例SVI患者进行回顾性图表分析。收集患者人口统计学、危险因素、临床-病因-解剖-病理生理（CEAP）分类、静脉临床严重程度评分（VCSS）和PROs。该队列女性395人（73%），男性150人（28%），中位年龄62岁（平均60±14），中位BMI为27 kg/m2（平均28±7）。大多数患者为白人（n=459, 84%）， 19名（4%）黑人或非裔美国人，7名（1%）亚洲人，39名（7%）其他种族，21名（4%）拒绝透露。382例（70%）患者既往有静脉疾病，163例（30%）患者无静脉疾病史。患者在接受RFA和UGFS治疗前后完成了两项PROs: HASTI和SF-6D。数据分析采用描述性统计和配对t检验比较治疗前后的结果。结果：患者以女性居多（72%），平均年龄60±14岁，平均BMI 28±7。治疗前症状的平均持续时间超过一年，最常见的症状包括疼痛、沉重/疲倦和痉挛。在66%的女性患者中观察到，既往妊娠是SVI最突出的危险因素。所有的HASTI和SF-6D测量均显示症状评分有所改善。VCSS也显著改善，由6.0±2.9降至3.9±2.6 （p < 0.001）。结论：SVI患者合并RFA后进行UGFS治疗，除了降低VCSS外，还显著改善了疾病特异性（HASTI）和一般（SF-6D）生活质量指标。

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引用次数: 0

Limb volumetry using an iPad-Based three-dimensional scanner for the assessment of edema 使用基于ipad的三维扫描仪进行肢体体积测量以评估水肿。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-16 DOI: 10.1016/j.jvsv.2025.102291

Caiyu Gao MD, Furong Liu MD

引用次数: 0

Events of Interest 关注的事件

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-16 DOI: 10.1016/S2213-333X(25)00168-4

引用次数: 0

Information for Readers 读者资讯

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-16 DOI: 10.1016/S2213-333X(25)00167-2

引用次数: 0

Preliminary study on the application of contrast-enhanced ultrasound in lymphovenous anastomosis 超声造影在淋巴静脉吻合中的应用初探。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-14 DOI: 10.1016/j.jvsv.2025.102344

Jing Wang MMed , Min Lu MD , Mingxing Hu BMed , Liuyi Li BMed , Kui Zhang MMed , Xu Li MMed

Objective

To explore the value of lymphatic contrast-enhanced ultrasound (CEUS) in lymphovenous anastomosis (LVA), with a particular focus on its role in preoperative lymphatic localization.

Methods

On the basis of whether preoperative ultrasound lymphatic contrast imaging was performed, the lymphatic diameter and depth from the skin were measured. Patients were divided into two groups: indocyanine green (ICG, 21 patients) and ICG combined with CEUS (21 patients). The differences between the two groups were compared in terms of total surgery time; number of anastomoses; anastomosis time per lymphatic vessel; and limb volume reduction at 1 week, 1 month, and 3 months postoperatively. A P value of < .05 was considered to indicate statistical significance.

Results

In the ICG + CEUS group, the success rate of ultrasound contrast imaging was 95%. The average lymphatic diameter was 0.6 ± 0.2 mm, and the average depth from the skin was 5.3 ± 2.8 mm. Among these patients, 74% had lymphatic reflux, 55% had reflux into the dermis, and 36% had collateral vessel formation. Compared with the ICG group, the ICG + CEUS group had a significantly shorter total surgery time (320 ± 124 vs 398 ± 93 minutes; P = .005), shorter anastomosis time per lymphatic vessel (14 ± 2 vs 32 ± 15 minutes; P < .001), and more anastomoses (median 19 vs 12; P < .001). There were no significant differences between the two groups in terms of limb volume reduction at 1 week, 1 month, or 3 months postoperatively (P > .05).

Conclusions

CEUS can be a powerful supplement for locating lymphatic vessels before LVA.

目的：探讨淋巴造影增强超声（CEUS）在淋巴静脉吻合（LVA）中的应用价值，重点探讨其在术前淋巴定位中的作用。方法：根据术前是否行超声淋巴造影术，测量淋巴结直径及离皮肤深度。患者分为吲哚菁绿组（ICG， 21例）和ICG联合超声造影组（21例）。比较两组总手术时间的差异；吻合口数；每根淋巴管吻合时间；术后1周、1个月和3个月肢体体积减小。结果：ICG + CEUS组超声造影成功率为95%。平均淋巴管直径0.6±0.2 mm，平均离皮肤深度5.3±2.8 mm。在这些患者中，74%有淋巴反流，55%有反流进入真皮层，36%有侧支血管形成。与ICG组相比，ICG + CEUS组总手术时间明显缩短（320±124 min vs 398±93 min, p = 0.005），每根淋巴管吻合时间明显缩短（14±2 min vs 32±15 min, p < 0.001），吻合次数较多（中位19例vs 12例，P0.05）。结论：超声造影可作为LVA前淋巴管定位的有力补充。

{"title":"Preliminary study on the application of contrast-enhanced ultrasound in lymphovenous anastomosis","authors":"Jing Wang MMed , Min Lu MD , Mingxing Hu BMed , Liuyi Li BMed , Kui Zhang MMed , Xu Li MMed","doi":"10.1016/j.jvsv.2025.102344","DOIUrl":"10.1016/j.jvsv.2025.102344","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the value of lymphatic contrast-enhanced ultrasound (CEUS) in lymphovenous anastomosis (LVA), with a particular focus on its role in preoperative lymphatic localization.</div></div><div><h3>Methods</h3><div>On the basis of whether preoperative ultrasound lymphatic contrast imaging was performed, the lymphatic diameter and depth from the skin were measured. Patients were divided into two groups: indocyanine green (ICG, 21 patients) and ICG combined with CEUS (21 patients). The differences between the two groups were compared in terms of total surgery time; number of anastomoses; anastomosis time per lymphatic vessel; and limb volume reduction at 1 week, 1 month, and 3 months postoperatively. A <em>P</em> value of < .05 was considered to indicate statistical significance.</div></div><div><h3>Results</h3><div>In the ICG + CEUS group, the success rate of ultrasound contrast imaging was 95%. The average lymphatic diameter was 0.6 ± 0.2 mm, and the average depth from the skin was 5.3 ± 2.8 mm. Among these patients, 74% had lymphatic reflux, 55% had reflux into the dermis, and 36% had collateral vessel formation. Compared with the ICG group, the ICG + CEUS group had a significantly shorter total surgery time (320 ± 124 vs 398 ± 93 minutes; <em>P</em> = .005), shorter anastomosis time per lymphatic vessel (14 ± 2 vs 32 ± 15 minutes; <em>P</em> < .001), and more anastomoses (median 19 vs 12; <em>P</em> < .001). There were no significant differences between the two groups in terms of limb volume reduction at 1 week, 1 month, or 3 months postoperatively (<em>P</em> > .05).</div></div><div><h3>Conclusions</h3><div>CEUS can be a powerful supplement for locating lymphatic vessels before LVA.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 1","pages":"Article 102344"},"PeriodicalIF":2.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A giant phlebolith in the inferior vena cava discovered incidentally during retrieval of the inferior vena cava filter 在取下腔静脉滤器时偶然发现的下腔静脉巨型静脉石。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-10 DOI: 10.1016/j.jvsv.2025.102340

Xuanfeng Zhu MM , Jindi Wei MM , Peng Gao MM , Ruiyuan Yang MSc , Xiquan Zhang MD

引用次数: 0

Meta-analysis of duration of venous thromboembolism risk following hospitalization in surgical and medical patients 外科和内科患者住院后静脉血栓栓塞风险持续时间的meta分析。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-10-10 DOI: 10.1016/j.jvsv.2025.102343

Georges Jreij MD , Caroline Crone BS , Aidan Wiley BA , Aman Kankaria DO , Mary S. Lin MD , Minerva Mayorga-Carlin MPH , Shalini Sahoo MA , John D. Sorkin MD, PhD , Brajesh K. Lal MD

Objective

Hospitalization increases venous thromboembolism (VTE) risk, and over one-half of all VTE events occur after hospital admission. Current decisions on post-hospitalization VTE prophylaxis are not evidence-based. The duration of enhanced risk after hospitalization, in surgical and medical patients, is not well-known. In this meta-analysis, we evaluated the rates of post-hospitalization VTE over time in patients that underwent surgery during their hospitalization and those that did not.

Methods

A literature search was performed through November 2023 using PubMed, EMBASE, and Cochrane. Studies examining the incidence of VTE in hospitalized patients during a specified period following hospitalization were included. Studies were excluded if they focused on nonhospitalized patients, failed to define the follow-up duration, or did not report the incidence of VTE. Screening and data collection was conducted by two reviewers.

Results

From a total of 1504 studies screened, 57 were included. Overall, 9,152,616 patients were included; of these, 1,232,627 were followed for 30 days, 28,522 for 45 days, 2,515,940 for 90 days, and 5,375,527 were followed beyond 90 days. The pooled incidence of VTE during the first 45 days was 0.3% (95% confidence interval [CI], 0.2%- 0.4%) among surgical patients and 4.6% (95% CI, 4.3%-4.9%) among medical patients. The pooled incidence of VTE during the first 90 days was 1.3% (95% CI, 0.7%-2.3%) in surgical patients and 2.9% (95% CI, 2.0%-4.1%) in medical patients. Beyond 90 days (between 180 and 1020 days), the pooled incidence of VTE was 1.0% (95% CI, 0.4%-2.3%) in the surgical cohort, compared with 2.3% (95% CI, 1.6%-3.5%) in the medical cohort.

Conclusions

The post-hospitalization 90-day VTE rate was found to be low for both surgical and medical patients; the risks beyond 90 days was found to be only slightly lower. VTE risk in surgical patients is predominantly short-term and diminishes following recovery from surgery. Conversely, medical patients exhibit a prolonged VTE risk, likely related to persistence of clinical risk factors.

目的：住院增加静脉血栓栓塞的风险，超过一半的静脉血栓栓塞事件发生在住院后。目前关于住院后静脉血栓栓塞预防的决定是没有证据的。在外科和内科患者中，住院后风险增加的持续时间尚不清楚。在这项荟萃分析中，我们评估了住院期间接受手术和未接受手术的患者的住院后静脉血栓栓塞率。方法：通过PubMed、EMBASE和Cochrane检索到2023年11月的文献。研究纳入了住院患者在住院后特定时期内静脉血栓栓塞发生率的研究。如果研究集中于非住院患者，未能确定随访时间，或未报告静脉血栓栓塞的发生率，则排除研究。筛选和数据收集由两名审稿人进行。结果：在总共1504项研究中，57项被纳入。总体而言，纳入了9,152,616例患者；其中，30天随访12232627人，45天随访28522人，90天随访2515940人，90天以上随访5375527人。手术患者前45天静脉血栓栓塞总发生率为0.3%(95%可信区间[CI]: 0.2; 0.4)，内科患者为4.6%（95%可信区间：4.3-4.9）。手术患者前90天内静脉血栓栓塞的总发生率为1.3% (95% CI: 0.7-2.3)，内科患者为2.9% （95% CI: 2.0-4.1）。超过90天（180 - 1020天），手术组静脉血栓栓塞总发生率为1.0% (95% CI: 0.4-2.3)，而医学组为2.3% （95% CI: 1.6-3.5）。结论：外科和内科患者住院后90天静脉血栓栓塞发生率均较低；超过90天的风险仅略低。手术患者的静脉血栓栓塞风险主要是短期的，并随着手术恢复而降低。相反，内科患者的静脉血栓栓塞风险延长，可能与临床风险因素的持续存在有关。

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