Association Between Prolonged Immobilization and Venous Thromboembolism in Hospitalized Medical Patients

Background Venous thromboembolism (VTE) is a potentially life-threatening but preventable complication among hospitalized medical patients. Objective To evaluate the association between the duration of immobilization and the risk of VTE (deep vein thrombosis and/or pulmonary embolism) in hospitalized medical patients. Methodology The analytical observational study was conducted at two tertiary care hospitals in Peshawar, namely, Lady Reading Hospital and Hayatabad Medical Complex, from January 2025 to December 2025. Consecutive sampling of 410 hospitalized medical patients ≥18 years of age resulted in the enrollment of all patients. Patients were excluded if they had a prior history of VTE and/or therapeutic anticoagulation. Immobilization was categorized as mild (<24 hours of restricted movement), moderate (24-72 hours of reduced mobility), and prolonged (>72 hours of complete or near-complete bed rest). Diagnosis of VTE was made with Doppler ultrasonography and computed tomography (CT) pulmonary angiography. The data were analyzed using SPSS version 26 (IBM Corp., Armonk, NY). A chi-square test and multivariable logistic regression were performed, and a p-value of ≤ 0.05 was deemed to be significant. Results Among 410 patients, VTE occurred in 68 (16.59%) cases, while 342 (83.41%) remained free of VTE. The incidence of VTE was higher for patients with increased immobilization, occurring in 8/146 (5.48%) patients with mild immobilization, 22/162 (13.58%) with moderate immobilization, and 38/102 (37.25%) with prolonged immobilization (p < 0.001). Prolonged immobilization was the strongest independent predictor of VTE with an adjusted odds ratio of 4.68 (95% CI: 2.72-8.05). Conclusion Prolonged immobilization is independently associated with increased odds of VTE among hospitalized medical patients.

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