Venous Thromboembolism (VTE), a lethal combination of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), claims over 840,000 lives globally each year—equivalent to one death every 37 seconds. More alarmingly, 60% of VTE events occur during hospitalization, making it the leading cause of unplanned in-hospital deaths. In China, the incidence of VTE continues to rise, reaching 14.2 per 100,000 population in 2021, with over 200,000 absolute cases. From postoperative elderly patients to business travelers on long-haul flights, thrombotic risks may lurk silently—a stark reminder of VTE’s insidious nature and widespread prevalence.

I. Who Is at Risk? Profiling High-Risk Groups

The following populations require heightened vigilance:

1. Sedentary "Invisible Victims"
   Prolonged sitting (>4 hours) significantly slows blood flow. For example, a programmer surnamed Zhang developed sudden leg swelling after consecutive overtime shifts and was diagnosed with DVT—a classic consequence of venous stasis.

2. Iatrogenic Risk Groups

   • Surgical Patients: Post-joint replacement patients face a 40% VTE risk without prophylactic anticoagulation.
   • Cancer Patients: VTE-related deaths account for 9% of all cancer mortalities. A lung cancer patient surnamed Li, who did not receive concurrent anticoagulation during chemotherapy, succumbed to PE—a cautionary tale.
   • Pregnant Women: Hormonal changes and uterine compression of blood vessels led to a pregnant woman surnamed Liu experiencing sudden dyspnea in her third trimester, later confirmed as PE.

3. Chronic Disease Patients with Compounded Risks
   Elevated blood viscosity in obese and diabetic individuals, coupled with reduced cardiac output in heart failure patients, creates a fertile ground for thrombosis.

Critical Alert: Seek immediate medical attention for sudden unilateral leg swelling, chest pain with suffocation, or hemoptysis—this is a race against time.

II. Tiered Defense System: From Foundational to Precision Prevention

1. Foundational Prevention: The "Three-Word Mantra" for Thrombosis Prevention
   • Move: Engage in 30 minutes of daily brisk walking or swimming. For office workers, perform ankle pump exercises (10 seconds of dorsiflexion + 10 seconds of plantarflexion, repeated for 5 minutes) every 2 hours. Peking Union Medical College Hospital’s nursing department found this increases lower limb blood flow by 37%.
   • Hydrate: Drink one cup of warm water upon waking, before bed, and during nighttime awakenings (total 1,500–2,500 mL/day). Cardiologist Dr. Wang often advises patients: "One cup of water may dilute one-tenth of your thrombosis risk."
   • Eat: Consume salmon (rich in anti-inflammatory Ω-3), onions (quercetin inhibits platelet aggregation), and black fungus (polysaccharides reduce blood viscosity).
2. Mechanical Prevention: Driving Blood Flow with External Devices
   • Graduated Compression Stockings (GCS): A pregnant woman surnamed Chen wore GCS from week 20 of pregnancy until postpartum, effectively preventing varicose veins and DVT.
   • Intermittent Pneumatic Compression (IPC): Orthopedic postoperative patients using IPC saw a 40% reduction in DVT risk.
3. Pharmacological Prevention: Stratified Anticoagulation Management
   Based on Caprini Score:

   Risk Tier	Typical Population	Prevention Protocol
   Low (0–2)	Young minimally invasive surgery patients	Early mobilization + IPC
   Moderate (3–4)	Laparoscopic major surgery patients	Enoxaparin 40 mg/day + IPC
   High (≥5)	Hip replacement/advanced cancer patients	Rivaroxaban 10 mg/day + IPC (4-week extension for cancer patients)

Contraindication Alert: Anticoagulants are contraindicated in active bleeding or platelet counts <50×10⁹/L. Mechanical prevention is safer in such cases.

III. Special Populations: Tailored Prevention Strategies

1. Cancer Patients
   Assess risk using the Khomana model: A lung cancer patient surnamed Wang with a score ≥4 required daily low-molecular-weight heparin. The novel PEVB barcode assay (96.8% sensitivity) enables early identification of high-risk patients.

2. Pregnant Women
   Warfarin is contraindicated (teratogenic risk)! Switch to enoxaparin, as demonstrated by a pregnant woman surnamed Liu who safely delivered after anticoagulation until 6 weeks postpartum. Cesarean delivery or comorbid obesity/advanced maternal age warrants immediate anticoagulation.

3. Orthopedic Patients
   Anticoagulation must continue ≥14 days post-hip replacement and 35 days for hip fractures. A patient surnamed Zhang developed PE after premature discontinuation—a lesson in adherence.

IV. 2025 China Guideline Updates: Breakthrough Advances

1. Rapid Screening Technology
   Westlake University’s Fast-DetectGPT achieves 90% accuracy in identifying AI-generated text, operating 340 times faster—aiding journals in filtering low-quality AI submissions.

2. Enhanced Treatment Protocols

   • Introduction of "catastrophic PTE" (systolic BP <90 mmHg + SpO₂ <90%), triggering multidisciplinary PERT team intervention.
   • Reduced apixaban dosage recommended for renal impairment (eGFR 15–29 mL/min).

V. Collective Action: Eradicating Thrombosis Through Universal Engagement

1. Healthcare Institutions
   Complete Caprini scoring within 24 hours of admission for all inpatients. Peking Union Medical College Hospital reduced VTE incidence by 52% after implementing this protocol.

2. Public Self-Management
   A 5% weight reduction in individuals with BMI >30 lowers thrombosis risk by 20%! Smoking cessation and glycemic control (HbA1c <7%) are critical.

3. Technology Accessibility
   Scan codes for ankle pump exercise tutorials. IPC device rental services now cover 200 cities.

Core Message: VTE is a preventable, controllable "silent killer." Begin with your next ankle pump exercise. Begin with your next glass of water. Keep blood flowing freely 

References

1. Yantai Municipal Government. (2024). Health Education on Venous Thromboembolism.
2. Chinese Guidelines for Thrombotic Disease Prevention and Treatment. (2025).
3. Chinese Academy of Sciences Institute of Physics and Chemistry. (2025). New Advances in VTE Risk Prediction for Cancer Patients.
4. Public Health Education. (2024). Foundational Prevention for VTE High-Risk Populations.
5. Westlake University. (2025). Fast-DetectGPT Technical Report.