Each year, an estimated 200,000 to 600,000 Americans will suffer from DVT; among them, 60,000 to 200,000 will suffer a fatal pulmonary embolism (PE).1 Unfortunately, very few of the patients at risk for DVT receive the preventive measures that can reduce the risk of DVT and PE.2
In 2004, an expert panel comprised of doctors from all key specialties and CKHS hospitals met to review the literature, adopt screening criteria, and decide on possible preventive measures for both moderate-to-high and high-risk medical (or non-surgical) patients.
An algorithm to determine risk and orders for prophylaxis was developed.
Risk factors for developing DVT include:
- Age of more than 62 years
- Anticipated bed confinement longer than 72 hours
- History of Deep Vein Thrombosis and or Pulmonary Embolism
- Obesity
- Immobilization
- Acute Myocardial Infarction
- Congestive Heart Failure
- Ischemic stroke with paralysis
- Major surgery - abdominal/pelvic/joint replacement
- Malignancy
- Trauma
- Post Partum
- Acute infection/sepsis
- Major surgery, including pelvic and joint replacement/surgery within the last three months
Performance Measures
All patients should be screened on admission for risk of developing DVT and all patients at risk should be placed on a mechanical or pharmacologic method of prophylaxis.
References
1. American Public Health Association, "Deep Vein Thrombosis: Advancing Awareness to Protect Patient Lives." [white paper] Public Health Leadership Conferences on Deep-Vein Thrombosis, Washington, DC, February 26, 2003, page 1.
2. Ibid, page 2.
Related Information
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Bates, Shannon M., M.D.C.M., and Jeffrey S. Ginsberg, M.D. “Treatment of Deep-Vein Thrombosis.” The New England Journal of Medicine 2004 Jul 15; 351(3):268-77.
No Abstract
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William MD, FCCP, et al. “Prevention of Venous Thromboembolism, The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.” Chest 2004 Sep;126(3 Suppl):338S-400S.
Abstract