Muchintala R, Khan A, Kalia K, et al.
Cureus. 2025;17(6):e86370. doi:10.7759/cureus.86370
This large retrospective cohort study using the MIMIC-IV database evaluated the association between missed pharmacologic venous thromboembolism (VTE) prophylaxis and outcomes in ICU patients. Among 65,355 adult patients, 85.6% received VTE prophylaxis, while 14.4% did not. Patients who missed prophylaxis had significantly shorter ICU length of stay (1.80 vs. 3.80 days) but notably higher in-hospital mortality (17.1% vs. 11.6%, p < 0.001). After adjustment for age, sex, and emergency admission, those who received prophylaxis had 65% lower odds of in-hospital death (OR: 0.35; 95% CI: 0.34–0.37). These findings underscore the critical importance of consistent VTE prevention strategies in the ICU and suggest that missed prophylaxis is both common and potentially fatal. System-level solutions such as electronic alerts, standardized order sets, and performance tracking may help improve compliance and patient safety.
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