Thousands of patients in England continue to develop serious blood clots, such as Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), during or shortly after hospital stays, according to a recent analysis by the Nuffield Trust. These clots, often referred to as hospital-acquired venous thromboembolism (VTE), represent a persistent challenge for the NHS, despite national guidelines and significant efforts to reduce their incidence.
VTE is a major cause of preventable hospital death and morbidity. DVT typically involves a blood clot in a deep vein, usually in the leg, while PE occurs when a part of this clot breaks off and travels to the lungs, potentially causing life-threatening complications. Patients are at increased risk of VTE during and after hospitalisation due to factors such as reduced mobility, surgery, injury, and underlying medical conditions.
The Nuffield Trust's examination underscores that while preventative measures, including pharmacological prophylaxis (anticoagulant medication) and mechanical methods (such as compression stockings), are widely implemented, the problem has not been eradicated. The analysis points to the complexity of identifying all at-risk patients and ensuring consistent adherence to preventative protocols across diverse clinical settings. This ongoing issue places additional strain on NHS resources, requiring further treatment and potentially longer hospital stays for affected individuals.
NHS guidelines, informed by recommendations from the National Institute for Health and Care Excellence (NICE), stipulate that all adult patients admitted to hospital should undergo a VTE risk assessment. This assessment helps determine whether a patient requires preventative treatment. Despite these comprehensive guidelines, the Nuffield Trust's findings suggest there may be gaps in implementation or a need for enhanced strategies to protect vulnerable patients.
The practical implications for UK patients are significant. Developing a blood clot can lead to chronic pain, swelling, and skin changes in the affected limb (post-thrombotic syndrome) after DVT, and can cause breathlessness, chest pain, and even sudden death in the case of PE. For the NHS, managing VTE and its complications incurs substantial costs, both in terms of direct medical care and the long-term support required for patients suffering from chronic conditions as a result of a clot.
Patients who have recently been discharged from hospital or are currently admitted are encouraged to discuss their personal risk of blood clots with their healthcare team. Symptoms of DVT include pain, swelling, and tenderness in one leg (usually the calf or thigh), while PE symptoms can include sudden breathlessness, chest pain, and coughing. Anyone experiencing these symptoms should seek urgent medical attention.
Source: Nuffield Trust