Risk of venous thrombosis and pulmonary embolism in older in-patients with mental illness: systematic review

Aims and method Venous thromboembolism (VTE) is a fatal condition affecting older people. This study aims to identify specific risk factors for VTE in older psychiatric in-patients within mental hospital settings. Using predefined search terms, we searched five databases to capture studies evaluating risk factors associated with the occurrence of deep vein thrombosis and pulmonary embolism in older psychiatric in-patients. Results Thirteen studies were identified, and a narrative synthesis performed. Increasing age was a consistent risk factor for VTE. Diagnosis and psychotropic medication use were inconsistent. Depression, catatonia and use of restraint in people with dementia were associated with higher risks. Clinical implications Older psychiatric in-patients differ from medical and surgical in-patients in their risk profiles. Screening tools used in general hospital patients are of limited use among older adults in psychiatric hospital settings. An exclusive screening tool to identify VTE risk factors in older psychiatric in-patients is needed.