Postoperative venous thromboembolism (VTE) incidence, timing, and thromboprophylaxis practices differ significantly across surgical subspecialties, impacting patient management strategies.

• Of 1,520 patients with VTE, medians were 4 days to VTE development, with pulmonary embolism occurring significantly earlier than deep vein thrombosis (3 vs 6 days).
• Neurosurgery had the highest incidence of VTE (0.23%), while orthopedic surgery had the highest relative risk.
• Only 76% of patients received thromboprophylaxis, starting a median of 1.3 days post-surgery; those without prophylaxis developed VTE much sooner (2.0 vs 4.0 days).

This study underscores the need for tailored VTE assessment and prophylaxis approaches depending on surgical specialty.