Objective To explore the clinical characteristics, treatment strategies and bleeding risk of inpatients complicated with venous thromboembolism (VTE) in the department of neurology.

Methods The clinical features and treatment outcomes of patients with VTE events in the Department of Neurology of Zhongshan Hospital, Fudan University from January 2014 to December 2020 were retrospectively analyzed.

Results A total of 77 patients were collected, including 43 males and 34 females, with an average age of (69.0±11.9) years. The most common underlying diseases of the neurology department were ischemic stroke, cerebral hemorrhage, central nervous system infection, and myelopathy. The overall mortality rate was 2.6%(2/77). There were 62 (80.5%) patients with pulmonary embolism (PE), 40(51.9%) patients with deep vein thrombosis (DVT), 25(32.5%) patients with both PE and DVT, 14(22.6%) PE patients with clinical symptoms, and 5(12.5%) DVT patients with clinical symptoms. The D-dimer level of all patients was (4.9±6.7) mg/L at admission and (11.7±9.9) mg/L at the diagnosis of VTE. For ischemic stroke, cerebral hemorrhage, and other rare diseases, the incidence of bleeding events in the three groups was 20%, 37.5%, and 20.8%, respectively, and the incidence of clinically significant severe bleeding events in the three groups was 7.5%, 25%, and 12.5%, respectively. There was no significant difference in the incidence among the three groups. The bleeding risk of all patients receiving anticoagulant was assessed by HAS-BLED. A total of 38 patients (52.8%) were in the low-risk group (< 3 points) and 34 patients (47.2%) in the high-risk group (≥ 3 points). There was no significant difference in the bleeding risk between the two groups.

Conclusions The occurrence of VTE in neurology patients is occult, and VTE screening strategy should be established for these subclinical patients. Anticoagulant therapy has a certain risk of bleeding, and the benefit-risk balance should be properly evaluated.