Hisam Siddiqi: Revisiting the Classic List of Risk Factors for Venous Thromboembolism
Hisam Siddiqi, Consultant Haematologist at LycaHealth, The Blackheath Hospital, Dartford and Gravesham NHS Trust, shared a post on LinkedIn:
”Rethinking VTE Risk Factors – Beyond the Checklist
I recently revisited the classic list of risk factors for venous thromboembolism (VTE) — but this time, with practical, real-world reflections added.
A few key takeaways from my annotations:
Not all thrombophilia tests are equal
Factor V Leiden and Prothrombin mutations are common but often over-interpreted.
They rarely dictate long-term anticoagulation decisions in isolation.
Focus on what truly matters
Protein C, Protein S, and Antithrombin deficiencies remain clinically meaningful and should be part of a thoughtful thrombophilia screen.
Always think acquired causes
Antiphospholipid syndrome, malignancy, inflammation, immobility — these often carry greater weight than inherited risks.
Don’t miss the basics
- Line-associated thrombosis – often preventable with good care
- Surgery risk persists up to 90 days
- Always ask about COCP in young patients
- Obesity plus immobility equals underestimated contributors
Look deeper when indicated
- Consider MPNs – check JAK2 / CALR / MPL
- Nephrotic syndrome – think antithrombin loss
- Unprovoked VTE – screen for underlying malignancy appropriately
Context is everything Risk factors don’t act in isolation — it is the combination, timing, and clinical scenario that should guide decision-making.
Teaching point:
Thrombosis is rarely explained by a single lab result.
Clinical judgement remains the most powerful tool we have.”
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