VTE Awareness Month

Jason Stein, MD, knows he could walk into almost any nursing unit in any hospital in the country, ask a simple question, and get blank stares in return.

“I would ask, ‘Which patients here in the nursing unit don’t have an order for VTE prophylaxis?’ ” says Dr. Stein, associate director for quality improvement and assistant professor of medicine at Emory University School of Medicine in Atlanta. “And they would tell me, ‘What kind of place do you think this is? How can we possibly know that?’ ”

It’s not idle chat. Venous thromboembolism (VTE) is a condition known throughout HM for three things: It runs rampant in hospitals; it can be deadly; and it’s easily preventable.

This month, SHM—along with dozens of other healthcare organizations, including the Agency for Healthcare Research Quality (AHRQ)—is highlighting the dangers of VTE and deep vein thrombosis (DVT), and promoting best practices to prevent them.

“SHM’s leadership of awareness efforts and championing VTE [prevention] has played an important role in keeping this on everybody’s mind,” Dr. Stein says.

VTE: A Hospital-Based Epidemic

Although it is easy to target at-risk populations and prevent it, VTE is widespread and dangerous.

“By published estimates, each year VTE kills more people than HIV, car accidents, and breast cancer combined,” says Gregory A. Maynard, MD, Ms, chief of the division of hospital medicine and clinical professor of medicine at the University of California at San Diego.

The risk of VTE in hospital patients should give hospitalists and their colleagues pause. Here’s why:

  • According to the American Heart Association, more than 200,000 cases of VTE are reported each year, and VTE occurs for the first time in approximately 100 out of every 100,000 persons each year;
  • Research published last year in The Lancet estimates 52% of hospitalized patients are at risk for VTE;
  • 1 in 3 VTE patients experiences a pulmonary embolism;
  • 30% of new VTE patients die within three days;
  • 20% of new VTE patients die suddenly from pulmonary embolus; and
  • DVT is responsible for approximately 8,000 hospital discharges every year. Pulmonary embolism accounts for nearly 100,000.

DVT Facts and Figures

  • More people suffer from DVT annually than from heart attack or stroke;
  • Approximately 600,000 people are hospitalized in the U.S. each year for DVT and its primary complication, pulmonary embolism (PE);
  • DVT-related PE is the most common cause of preventable hospital death;
  • Only one-third of hospitalized patients with risk factors for blood clots receive prophylactic DVT treatments;
  • Without prophylactic DVT treatment, up to 60% of patients who undergo total hip replacement surgery may develop DVT;
  • Cancer patients undergoing surgical procedures have at least twice the risk of postoperative DVT and more than three times the risk of fatal PE than non-cancer patients undergoing similar procedures; and
  • In the elderly, DVT is associated with a 21% one-year mortality rate, and PE is associated with a 39% one-year mortality rate.

Source: The Coalition to Prevent Deep-Vein Thrombosis

About Brendon Shank

Brendon Shank joined the Society of Hospital Medicine in February 2011 and serves as Associate Vice President of Communications. He is responsible for maintaining a dialogue between SHM and its many audiences, including members, media and others in healthcare.

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