A new NICE guideline on treating blood clots in hospital patients could mark a significant advance in the prevention of an estimated 25,000 avoidable deaths.
The guideline sets out simple steps to help prevent venous thromboembolism (VTE), which covers both deep vein thrombosis (DVT) and its possible consequence pulmonary embolism (PE).
An estimated 25,000 people who are admitted to hospital die from preventable venous thromboembolism each year. PE is the immediate cause of 10% of all hospital deaths, a rate greater than the combined total from breast cancer, AIDS and traffic accidents.
The NICE guideline, jointly developed with the National Clinical Guideline Centre for Acute and Chronic Conditions, recommends that all patients should be assessed for risk of developing blood clots on admission to hospital and then given preventative treatment that suits their individual needs.
These options include blood-thinning drugs such as heparin, anti-embolism stockings and foot impulse or pneumatic devices. The advice covers all patients admitted to hospital – including those having day-case procedures – and not just those patients having surgery.
Professor Tom Treasure, Chair of the NICE Guideline Development Group and Professor of Cardio-Thoracic Surgery, said: “Put simply, all patients without exception should be assessed on being admitted to hospital for risk of developing a blood clot, and then given preventative treatment that is appropriate for them. VTE is a silent killer – so it’s the responsibility of medical professionals to take the very simple steps set out in the guideline, which can help prevent unnecessary deaths and long-term illnesses.”
Publication of new NICE guidelines follow a recent DH initiative that will further encourage hospitals to implement risk assessment and prevention of hospital-acquired VTE by offering financial incentives for compliance. This initiative will operate through the CQUIN (Commissioning for Quality and Innovation) payment framework.
Professor Beverley Hunt, Medical Director of Lifeblood: the thrombosis charity and a member of the NICE Guideline Development Group, said: “Having the Trusts penalised if they don’t adequately risk-assess is great news for patients. The NICE Guidelines clearly outline what protection patients at risk from VTE should expect. With the new CQUIN targets in place, hospital managers have now been forced to make this a priority, with those Trusts that fail to meet the new targets facing significant fines.”
In response to the guidelines, Bayer Schering Pharma has launched a Thromboprophylaxis Assessment and Implementation Toolkit Route Map for anyone who is involved in the provision, management and commissioning of VTE thromboprophylaxis services.