Greater use of preventive measures needed for hospitalized patients with suspected venous thromboembolism
Research Activities, January 2011, No. 365
Hospital patients who are undergoing diagnostic tests for venous thomboembolism (VTE) often do not get adequate preventive treatment while being evaluated, a new study suggests. VTE conists of two related conditions, deep vein thrombosis (DVT), a blood clot in a deep vein in the leg, and pulmonary embolism (PE), a lung clot that dislodges from the leg to travel to the lungs. PE is the most common preventable cause of hospital death in the United States. One-fifth (21 percent) of the 600 hospitalized patients at an academic medical center referred for suspected VTE were diagnosed with acute VTE. The incidence of DVT and PE among patients undergoing the specific tests for each disorder was 18 percent for DVT and 25 percent for PE. Although preventive measures are recommended for all patients suspected of being at risk of VTE, only 61 percent of eligible patients received prophylactic anticlotting drugs and 43 percent received mechanical prophylaxis (sequential compression devices or graduated compression stockings for their legs).
The researchers found that the incidence of VTE was higher in patients who did not receive anticlotting drugs (30 percent) than in those who had received this preventive treatment (16 percent). The researchers collected data on preventive strategies used with the patients, VTE treatment strategies, clinical outcomes associated with VTE (propagation of thrombus in the legs within 3 months of DVT diagnosis, major bleeding episodes within 3 months of starting anticoagulant therapy, mortality within 3 months of VTE diagnosis), and information on risk factors for VTE. The study was funded in part by the Agency for Healthcare Research and Quality (HS15898).
More details are in "The use of prophylaxis in patients undergoing diagnostic tests for suspected venous thromboembolism," by Jung-Ah Lee, Ph.D., and Brenda K. Zierler, Ph.D., R.N., in the April 2010 Phlebology 25(2), pp. 85-93.