Top Things to Know: Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients

Published: May 07, 2020

  1. Acute venous thromboembolism (VTE), comprising deep venous thrombosis (DVT) of the legs or pelvis and pulmonary embolism (PE), is a frequent, costly complication in hospitalized patients.
  2. VTE is a leading contributor to increased length of stay, and the primary cause of preventable hospital death in the US and worldwide.
  3. Most estimates place the US annual incidence of diagnosed VTE in adults at one to two per 1,000 per year, increasing with age, obesity, and occurring disproportionately in blacks.
  4. Primary prophylaxis in high-risk hospitalized medical and surgical patients is safe, clinically effective, and cost-effective for reducing VTE but is under-utilized.
  5. Provider and public awareness of VTE is low.
  6. Given that much of the morbidity and mortality from VTE is preventable, increased VTE awareness and prioritization of proven, evidence-based primary prevention strategies accompanied by uniform tracking of hospital-acquired VTE should be a national health priority.
  7. Treatment for acute VTE is estimated to incur direct medical costs of $12,000 to $15,000 (2014 US dollars) per individual in first-year survivors; between 10 to 30% of acute VTE survivors develop recurrent VTE within 5 years. 
  8. The projected annual cost of preventable hospital-acquired VTE is $7-10 billion per year.
  9. This statement presents five major areas of policy guidance that the AHA believes will lead to better VTE event prevention and tracking.
  10. The five areas covered in the statement are:
    1. Performing VTE risk assessment and reporting the level of VTE risk in all hospitalized patients
    2. Integrating preventable VTE as a benchmark for hospital comparison and pay-for-performance programs
    3. Supporting appropriations to improve public awareness of VTE
    4. National tracking of VTE using standardized definitions
    5. Developing a centralized data registry for tracking on VTE risk assessment, prevention, and rates

Citation


Henke PK, Kahn SR, Pannucci CJ, Secemksy EA, Evans NS, Khorana AA, Creager MA, Pradhan AD; on behalf of the American Heart Association Advocacy Coordinating Committee. Call to action to prevent venous thromboembolism in hospitalized patients: a policy statement from the American Heart Association. Circulation [published online ahead of print May 7, 2020]. doi: 10.1161/CIR.0000000000000769.