Top Things to Know: Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients
Published: May 07, 2020
- 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.
- VTE is a leading contributor to increased length of stay, and the primary cause of preventable hospital death in the US and worldwide.
- 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.
- Primary prophylaxis in high-risk hospitalized medical and surgical patients is safe, clinically effective, and cost-effective for reducing VTE but is under-utilized.
- Provider and public awareness of VTE is low.
- 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.
- 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.
- The projected annual cost of preventable hospital-acquired VTE is $7-10 billion per year.
- This statement presents five major areas of policy guidance that the AHA believes will lead to better VTE event prevention and tracking.
- The five areas covered in the statement are:
- Performing VTE risk assessment and reporting the level of VTE risk in all hospitalized patients
- Integrating preventable VTE as a benchmark for hospital comparison and pay-for-performance programs
- Supporting appropriations to improve public awareness of VTE
- National tracking of VTE using standardized definitions
- 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.