VTE - A Serious Threat
Assessing the risk of VTE for patients facing surgery
A study of the burden of venous thromboembolism
(VTE) in 6 countries within the European Union (EU) has estimated that the total number of symptomatic VTE
events is in excess of one million each year. Deaths attributable to VTE
in the Western hemisphere are estimated to exceed the total combined number of deaths from AIDS, breast cancer, prostate cancer, and road traffic accidents annually.46, 47
Many identifiable factors contribute to an increased risk of VTE
. The increased risk of VTE
in major orthopaedic surgery
can be linked to:6, 43
- Venous stasis, from post-operative immobility
- Damage to the vessel wall during the procedure
- Increased procoagulant activity, such as increased thrombin generation
VTE risk is a common, but preventable, complication in medically ill patients
Although many associate VTE
with recent trauma or surgery, 50% to 70% of symptomatic cases, as well as the majority of cases of fatal pulmonary embolism (PE), occur in medical (non-surgical, non-trauma) patients.6, 48
Because of the often silent nature of VTE
, the first sign of a problem may be a clinically significant event, such as PE
- 46 - Cohen AT, Agnelli G, Anderson FA, et al; VTE Impact Assessment Group in Europe (VITAE). Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007;98(4):756-764.
- 47 - Fitzmaurice DA, Murray E. Thromboprophylaxis for adults in hospital. BMJ. 2007;334(7602):1017-1018.
- 6 - Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):381S-453S.
- 43 - Merli GJ. Pathophysiology of venous thrombosis, thrombophilia, and the diagnosis of deep vein thrombosis-pulmonary embolism in the elderly. Clin Geriatr Med. 2006;22(1):75-92.
- 48 - Goldhaber SZ, Tapson VF; DVT FREE Steering Committee. A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis. Am J Cardiol. 2004;93(2):259-262.
- 49 - Kearon C. Natural history of venous thromboembolism. Circulation. 2003;107(23 suppl 1):I22-I30.
- Venous thromboembolism
- A disease process beginning with a blood clot occurring within the venous system, including deep vein thrombosis and pulmonary embolism.
- Major orthopaedic surgery
- Major operations on the bones or joints including total hip or knee replacement surgery.
- Enzyme in the blood clotting cascade that promotes the formation of blood clots.
- Pulmonary embolism
- A potentially fatal condition caused by a blood clot blocking a vessel in the lung: usually the clot originates from a DVT in the legs. PE can result in permanent lung damage.