Up to 60 percent of all venous thromboembolism (VTE) cases occur during or within 90 days of hospitalization, making it a leading preventable cause of hospital death.
Being in the hospital is a major risk factor for developing a VTE. Patients are more likely to develop blood clots if they have decreased mobility due to bedrest or recovery or if they experience blood vessel trauma due to surgery or other serious injury.
To prevent hospital-associated VTE and related morbidity, every hospital worldwide should establish and enforce a VTE protocol. Protocols may vary by institution and country, but should include a VTE risk assessment that is tied to proper prevention and treatment guidelines.
Medical Procedures with Increased VTE Risk
Certain surgeries and medical procedures are considered to increase the risk for VTE, including:
- Orthopedic surgery (e.g., total hip or knee surgery)
- Major general surgery (especially involving the abdomen, pelvis, hip or legs)
- Major gynecological surgery
- Urological surgery
- Cardiothoracic surgery
- Major peripheral vascular surgery
- Chemotherapy for cancer treatment
Preventing Hospital-Associated VTE
Research suggests that VTEs are often preventable, and evidence-based prevention strategies can stop the development of clots in ‘at-risk’ individuals.
To identify whether a patient is ‘at-risk,’ healthcare professionals should conduct a VTE risk assessment, which is tool or questionnaire that gathers information about a patient’s age, medical history, medications and specific lifestyle factors. Information is then used to discern a patient’s potential risk (e.g., high, moderate or low risk) for developing blood clots in the legs or lungs.
If you are admitted to a hospital, be proactive and ask for a VTE risk assessment.
8 Jha AK, Larizgoitia I, Audera-Lopez C, Prasopa-Plaisier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modeling of observational studies. BMJ Qual Saf 2013; 22;809-15. Retrieved from: http://qualitysafety.bmj.com/content/22/10/809.full.pdf+html
9 House of Commons Health Committee Report on the Prevention of Venous Thromboembolism in Hospitalized Patients. www.publications.parliament.uk/pa/cm200405/cmselect/cmhealth/99/9902.html.
10 Yusuf H, Tsai J, Atrash H, Boulet S, Grosse S. Venous thromboembolism in adult hospitalizations–United States – 2007-2009. MMWR 2012;61:no. 22:401-404
11 National Policy Framework: VTE Prevention in Adult Hospitalized Patients in NZ. New Zealand VTE Prevention. June 2012. http://www.hqsc.govt.nz/assets/Other-Topics/QS-challenge-reports/VTE-Prevention-programme-National-Policy-Framework.pdf