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04/13/2021

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Deep vein thrombosis: life-threatening but preventable
Compression device to prevent deep vein thrombosis

March is Deep Vein Thrombosis (DVT) Awareness Month, a public health initiative aimed at raising awareness among clinicians and patients of the dangers of DVT – otherwise known as a blood clot. DVT is remarkably prevalent in the U.S. According to the National Blood Clot Alliance, someone in the U.S. is diagnosed with a blood clot every minute; every six minutes, someone dies from a blood clot.

Though the statistics are startling, DVT is both highly preventable and treatable. Read on to learn more.

What is deep vein thrombosis?
“DVT is a serious kind of blood clot that forms in a deep vein – most commonly in a leg,” said Theresa Courtney, global vice president of Medical Affairs at Cardinal Health. “This type of clot can form when something prevents your blood from flowing normally through blood vessels.”

If left untreated, the blood clot can cause a pulmonary embolism (PE) ­– a potentially life-threatening situation where the clot travels to the lungs and blocks blood flow. DVT and PE are both forms of venous thromboembolism (VTE).

Nearly 60% of all deep vein blood clots occur during or shortly after hospital stays, making them one of the leading causes of avoidable hospital deaths, according to the journal BMJ Quality and Safety. They are also the fifth most frequent reason for unplanned hospital readmissions following surgery, according to the Centers for Disease Control and Prevention (CDC).

Though these blood clots are very common, they are also highly preventable.


What causes DVT?
DVT can be caused by anything that prevents blood in the deep veins from circulating properly through the legs and ankles. It can develop as a result of a vein disease, an injury to a vein or a clotting disorder. “A potentially fatal VTE is a condition that can affect nearly anyone, but the most vulnerable patients are those who have recently undergone surgery or trauma, and those who have cancer,” Courtney said. “Pregnant women also can be at greater risk of DVT.”

Though blood clots can occur any time, most often, DVT and PE happen either during or shortly after a hospitalization.  


What are the symptoms of DVT?
Unfortunately, DVT often has few symptoms, which means clinical staff need to be proactive with prevention efforts. In fact, about one-fourth of the people who experience a pulmonary embolism die without exhibiting any symptoms at all, according to the CDC.

For those who do experience symptoms, these are the most common:

  • Leg pain, most often in the calf, which may feel like a pulled muscle or cramp
  • Swelling, typically in one leg or arm
  • Unusual warmth in the affected leg or arm
  • Redness or bluish skin discoloration

Note: If you have any of these symptoms, contact your doctor right away.


How can DVT be prevented?
DVT is often identified as one of the most common preventable causes of hospital death. Studies have shown that as many as 70% of hospital-associated DVTs or PEs may be preventable.

Cardinal Health recently supported the year-long work of nearly 600 clinicians who created an International Consensus Statement (ICS) about how best to prevent VTEs in orthopedic procedures. (You can read more about the ICS, which was published in the Journal of Bone and Joint Surgery, here.) This work, led by Javad Parvizi, MD, orthopedic surgeon and director of Clinical Research at the Rothman Orthopaedic Institute, states that:

  • Mechanical compressive devices can be used routinely to prevent VTE in patients who undergo total hip or total knee replacements.
  • For the majority of surgical procedures, it appears that aspirin and intermittent pneumatic compression devices may be adequate for preventing VTE. 
  • The development of VTE is influenced by genetic and other patient-specific predispositions. Recognizing these factors may help tailor the VTE preventative measures accordingly. 

“In addition to following best practices for preventing DVT and PE in the hospital,” Courtney said, “it’s important for clinical staff to educate patients about what they need to do, both during their hospital stay and at home, to prevent clots when they’re discharged.”


What can patients do?
It’s important to know your own risks of getting blood clots, Courtney said. In addition to hospitalizations and major surgery, other risk factors include a family history of blood clots, being overweight, undergoing cancer treatments and smoking. Be sure to tell your doctor if you have any of these risk factors. If you do experience any of the symptoms of a blood clot as described above, see your doctor as soon as possible.

Finally, research shows that patient compliance with compression devices is critical towards the prevention of VTE, but many patients don’t use the devices as recommended: A review of studies found that as many as 25% of patients do not use their compression devices and stockings as they should.

“Patients may not realize that a compression device is so important for prevention, or may not understand how to use it correctly,” Courtney said. “If your doctor prescribes a compression device for you, be sure to ask plenty of questions so that you know how – and how long – you should use it.”

 

Editor’s note: Calling VTE prevention champions: In the hospital, clinical staff are at the front lines of prescribing the appropriate compression devices and encouraging patients to use them effectively. Cardinal Health and Becker’s Hospital Review are hosting a webinar, at no charge, called “Clot-busting: a multifaceted approach to VTE prevention,” designed specifically for these frontline staff. The webinar will take place Tuesday, March 29 at 2 p.m. ET and feature a quality nurse specialist sharing her work to dramatically decrease VTE rates. Register for the seminar now.