In a 16-year electronic health record cohort, hospital-captured documentation of early anticoagulation after VTE increased over time, whereas documentation of 90-day follow-up processes remained infrequent, with all four prespecified care domains documented in only 2.5% of patients overall.
Key Findings
Results
Documented therapeutic anticoagulation within 14 days of a VTE-related index event increased substantially across treatment eras.
Anticoagulation documentation rose from 34.1% in 2009–2014 to 58.0% in 2020–2024.
The study cohort comprised 5998 patients with a definable hospital-captured index VTE-related event.
Treatment eras were prespecified as 2009–2014, 2015–2019, and 2020–2024.
Data were drawn from a single-center retrospective EHR cohort at Peking University People's Hospital between 2009 and 2024.
Results
Hospital-captured clinical follow-up within 15–90 days after VTE was documented in fewer than one quarter of patients.
Clinical follow-up within 15–90 days was documented in 1483 of 5998 patients (24.7%).
Laboratory monitoring within the same window was documented in only 366 patients (6.1%).
VTE-related ultrasound or imaging reassessment within 15–90 days was documented in 578 patients (9.6%).
These figures reflect hospital-captured records only; care delivered outside the hospital system may not be captured.
Results
Completion of all four prespecified post-VTE care documentation domains was rare across the entire study period.
All four domains (therapeutic anticoagulation within 14 days; clinical follow-up, laboratory monitoring, and selective imaging within 15–90 days) were documented in only 149 patients (2.5%) overall.
Four-domain documentation completion reached 3.2% in the most recent era (2020–2024), still a low absolute rate.
The four-domain composite measure was a prespecified study-defined documentation outcome.
The low overall rate may reflect incomplete documentation or care delivered outside the hospital system.
Results
The 2020–2024 treatment era, pulmonary embolism presentation, and upper-extremity or catheter-related VTE were independently associated with higher odds of four-domain documentation completion.
These associations were identified in multivariable analysis.
Pulmonary embolism presentation was associated with higher odds of completing all four documented care domains compared to other VTE presentations.
Upper-extremity or catheter-related VTE was similarly associated with higher odds of four-domain documentation completion.
The 2020–2024 era was associated with higher odds relative to earlier eras, consistent with the temporal increase in anticoagulation documentation.
Methods
The study cohort had a median age of 64.0 years and was majority female.
Median age was 64.0 years.
55.3% of the 5998 patients were female.
Patients were included if they had VTE-related evidence and a definable hospital-captured index date.
The cohort was derived from vascular surgery outpatient and inpatient records at a single center over 16 years (2009–2024).
Discussion
The authors attributed low 90-day follow-up documentation rates to both incomplete hospital documentation and care delivered outside the hospital system.
The study explicitly notes that 'incomplete documentation or care delivered outside the hospital system may have contributed' to low follow-up rates.
The retrospective EHR design captures only hospital-recorded encounters and cannot ascertain care provided at community or primary care settings.
The authors highlight this as an opportunity 'to strengthen continuity and traceability of post-VTE management.'
What This Means
This research followed nearly 6,000 patients diagnosed with venous thromboembolism (blood clots, including deep vein thrombosis and pulmonary embolism) at a large Chinese hospital over 16 years (2009–2024). The researchers looked at whether hospital records showed patients receiving the recommended follow-up care in the 90 days after their blood clot diagnosis, including starting blood thinners quickly, returning for clinical check-ups, getting blood tests, and having imaging to reassess the clot. They found that while more patients had documented blood thinner prescriptions within the first two weeks over time—rising from about 34% to 58%—the rates of documented follow-up care in the subsequent weeks remained very low throughout the study period.
The most striking finding was that all four recommended care steps were documented together in only 2.5% of patients across the entire 16-year period, and this barely improved to 3.2% in the most recent years (2020–2024). Patients with pulmonary embolism (clots in the lungs) or clots related to catheters were more likely to have complete documentation. The researchers caution that some of this low rate may be because patients received follow-up care at community clinics or primary care offices that wouldn't appear in the hospital's records—but the hospital still couldn't track or coordinate that care.
This research suggests that even as newer, easier-to-use blood thinners (direct oral anticoagulants) have become standard, the structured follow-up process for blood clot patients—checking on treatment safety, deciding how long to continue medication, and reassessing clots when needed—is not being reliably captured in hospital records. This matters because decisions about how long to continue blood thinners and whether to adjust treatment are important for preventing clot recurrence and bleeding complications. The findings point to a need for better systems to track and ensure continuity of care for blood clot patients after they leave the hospital, regardless of where their follow-up care takes place.
Wang Y, Wang Y, Zhang X, Li W, Li W, Zhang T. (2026). Temporal Changes in Hospital-Captured 90-Day Care After Venous Thromboembolism: A 16-Year Electronic Health Record Cohort Study.. Vascular health and risk management. https://doi.org/10.2147/VHRM.S637373