Factors associated with venous thromboembolism in ICU patients with sepsis: A retrospective analysis using the MIMIC-IV database

This study used the MIMIC-IV v3.1 database to examine factors associated with venous thromboembolism (VTE) in adult ICU patients with sepsis, excluding those with prior VTE or ICU stays under 48 h. Among 14,784 eligible patients, 1,038 (7.0%) developed VTE during their ICU stay. Multivariable analysis identified that mechanical ventilation as one of the strongest positive associations among the included ICU interventions. Markers of disease severity and physiological disturbance were also associated with VTE, including higher maximum partial thromboplastin time, higher maximum white blood cell count, higher maximum respiratory rate, higher minimum mean arterial pressure, higher minimum sodium, and lower minimum calcium. Malignancy remained a significant factor, with malignant cancer and metastatic solid tumors independently associated with higher VTE risk. Renal disease and chronic pulmonary disease were inversely associated with VTE, which may reflect competing mortality risk and differential diagnostic opportunity rather than true biological protection. The findings suggest that acute physiological derangements, cancer-related factors, and ICU interventions are associated with VTE occurrence in septic ICU patients, underscoring the potential for early risk stratification and targeted prevention strategies in this population.