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Identifying the Appropriate Amount of VTE Prophylaxis in Hospitals

Posted Tuesday, July 3, 2018 by Morgan Cartwright

Venous thromboembolism (VTE) is a medical condition that occurs when a blood clot forms in the deep veins of the leg, groin or arm. It is also known as deep vein thrombosis (DVT). If the clot breaks off and travels in the circulation, it can block a blood vessel in the lungs, known as a pulmonary embolism (PE). It is treated through VTE prophylaxis, which refers to both pharmacological (blood thinners typically) and/or non-pharmacological (such as compression stockings) interventions to prevent VTE.

VTE can occur after major general surgery. However, the risk of VTE is different depending on the patient and procedure. PE has been shown to be one of the most common identifiable causes of death in hospitals in the United States. This creates a need for hospitals to recognize the level of risk and order the appropriate amount of VTE prophylaxis.

A recent study suggests that hospitals have been overusing VTE prophylaxis by giving too much to patients. Lower risk patients – those who are not recommended to get any prophylaxis – were giving blood thinners 57.1% of the time, and 77.9% were given at minimum a compression device such as compression stockings.

Higher risk patients have also been systematically given too much prophylaxis. 32.3% of such patients without a contraindication to blood thinning medication (a factor suggesting withholding) were given too much, and 26.9% for those with a contraindication to pharmacological treatments were given too much.

Hospitals have been overusing VTE prophylaxis to various degrees, which can be dangerous. The consequences of overuse include bleeding, impaired mobility, falls, discomfort, and other adverse effects.

Without properly identifying the appropriate amount of VTE prophylaxis, hospitals unnecessarily risk the safety of their patients.

Sources:

What is Venous Thromboembolism (VTE)?

Venous Thromboembolism Prophylaxis

Study: Hospitals Overuse VTE Prophylaxis

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