May 18 2007
Up to 25,000 people may die needlessly each year due to the failure to prevent blood clots known as venous thromboembolisms (VTE) in UK hospitals, say experts in this week's BMJ.
Their warning follows the publication of official guidelines on the issue last month by the National Institute for Health and Clinical Excellence (NICE), which are also summarised in this week's journal.
It is estimated that VTE kills around 60,000 people every year in the UK and the condition accounts for 10% of all hospital deaths, write David Fitzmaurice and Ellen Murphy from the University of Birmingham. This is 10 times greater than deaths due to MRSA and five times more deaths than breast cancer, AIDS and road traffic accidents combined.
People who have recently had surgery are particularly at risk.
Trials show that drugs can reduce the rate of VTE by up to 65%, yet a Health Select Committee report in 2005 found that only one in five patients at risk were getting them.
The committee instructed NICE to produce guidelines and called for an expert working group to develop a strategy and report back to the chief medical officer.
The expert group's report and the chief medical officer's response were published last month, recommending that every adult should have a mandatory VTE risk assessment on admission to hospital and that core standards be set to ensure full compliance with these assessments.
But despite the huge evidence base for preventative treatment, it remains poorly implemented in the UK, say the authors.
A combination of factors may be responsible, they say. For example, health professionals lack awareness due to poor education and venous thromboembolism often occurs after discharge from hospital. Prescribing costs may also be a barrier.
The Health Select Committee's report two years ago provided an opportunity to change practice, say the authors. Meanwhile, 25,000 people may have died needlessly each year because of the failure to implement simple thromboprophylaxis in UK hospitals, they conclude.