Did you know?
- Blood clots (DVT and PE) affect upwards of 600,000 Americans each year and cause more deaths each year than the more well-publicized conditions of breast cancer, AIDS,and motor vehicle accidents.[i]
- Blood clots are a leading cause of preventable hospital deaths in the United States. [ii]
- Blood clots are the leading cause of maternal death in the United States.[iii]
- One-half of clot patients will have long-term complications and one-third will have a recurrence within 10 years.[iv]
- An estimated $10 billion in medical costs in the US each year can be attributed to DVT and PE.[v]
What is DVT?
When a clot forms in the deep veins of the body, it is called deep vein thrombosis, often referred to as DVT for short. DVT occurs most commonly in the leg; although it can occur anywhere in the body, such as the veins in the arm, abdomen, or around the brain.
Symptoms of Deep Vein Thrombosis (DVT):
- Discoloration (bluish, purplish or reddish skin color)
A potentially life-threatening complication of deep vein thrombosis (DVT) is pulmonary embolism, often referred to as PE for short. A PE occurs when a blood clot breaks off, travels through the blood stream and lodges in the lung.
Symptoms of Pulmonary Embolism (PE):
- Shortness of breath
- Chest pain (which may be worse with deep breath)
- Unexplained cough (may cough up blood)
- Unexplained rapid heart rate
What Causes Blood Clots (DVT and PE)?
Blood clots may form when either the flow of blood in a vein slows, damage to a vein occurs, or the blood is more clotable. Many factors can increase a person’s risk for developing a blood clot in a vein. Common risk factors for developing a blood clot include:
· Being paralyzed
· Prolonged sitting
Surgery and Trauma:
· Major surgery (especially of the pelvis, abdomen, hip, knee)
· Bone fracture or cast
· Catheter in a big vein (PICC line, central venous catheter, or port)
· Birth control pills, patches, rings
· Pregnancy, including up to 6 weeks after giving birth
· Estrogen and progestin hormone therapy
· Cancer and chemotherapy
· Heart failure
· Inflammatory disorders (lupus, rheumatoid arthritis, inflammatory bowel disease)
· The kidney disorder called nephrotic syndrome
Other risk factors:
· Previous blood clot
· Family history of clots
· Clotting disorder (inherited or acquired)
· Older age
· Cigarette smoking
· Varicose veins
Tips for Preventing Blood Clots (DVT and PE)
- Stay active. Immobility increases the risk of developing clots. If you've been sitting for a long period of time (such as long-distance travel) stop and take a break to stretch your legs.
- Maintain an ideal body weight.
- Know your risk factors for developing a clot (above) and discuss these with your doctor.
- Know your family medical history. Make sure your doctor knows about any history of blood clots.
- If you are hospitalized or planning for surgery, ask your doctor: ‘What will be done to prevent blood clots?’ You may be given a blood-thinning medication (anticoagulant) or special stockings designed to prevent blood clots. These blood clot prevention measures are called 'DVT prophylaxis'.
Clot Connect, www.clotconnect.org, is an outreach program at the University of North Carolina at Chapel Hill which aims to address the need for improved education by serving as a comprehensive clearinghouse for reliable, clinically relevant information on prevention, diagnosis and treatment of blood clots. It is the only education program of its kind in the country. About 30,000 persons per month utilize the web based education resources and it is growing.
Many blood clots and their complications are preventable. The goal of education is to reduce morbidity and mortality from blood clots, which translates into:
- Fewer DVT and PE. DVT treatment costs alone are approximately $20,000 per patient with PE costs much higher.[vi]
- Fewer readmissions (due to poor anticoagulation management such as bleeds, recurrent clot). Among patients with a first time venous clot hospitalization, one study found that 25% had a hospital readmission with an average cost of $15,000.[vii]
- Less Emergency Room utilization (due to bleeds from anticoagulation, post-clot pain management)
- Fewer adverse outcomes (such as bleeding, post-thrombotic syndrome, pulmonary hypertension, recurrent clot)
In short, greater clot education can lead to better health care and better patient outcomes, at lower costs.
Contact Beth Waldron
Program Director, Clot Connect
Hemophilia and Thrombosis Center,
University of North Carolina at Chapel Hill
Direct message @ClotConnect on Twitter
[i] Nabel, Elizabeth MD (Director, NIH’s National Heart, Lung, and Blood Institute) in the Surgeon General’s Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism US Department of Health and Human Services 2008 p. 5.
[ii] Baglin TP, White K, Charles A. Fatal pulmonary embolism in hospitalized medical patients. J Clin Pathol 1997;50(7):609-10.
[iii] Berg CJ, Atrash HK, Koonin LM, Tucker M. “Pregnancy-related mortality in the United States 1987-1990”. Obstet Gynecol 1996;88(2):161-7 Also see Marik. P.E. and Plante, L.A. “Venous Thromboembolic Disease and Pregnancy”. New England Journal of Medicine, volume 359, number 19, November 6, 2008, pages 2025-2033.
[v] Gross, Scott. CDC “Incidence based cost-estimates require population based incidence data” 2012 http://www.cdc.gov/ncbddd/Grosse/cost-grosse-Thrombosis.pdf
[vi] Mahan et al “Deep vein thrombosis: A United States cost model for a preventable and costly adverse event” Journal of Thrombosis and Hemostasis 2011; 106: 405-415
[vii] Spyropoulos AC, Lin J. Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative claims analysis from 30 managed care organizations. J Manag Care Pharm.2007; 13: 475−486.