Page last updated at 00:33 GMT, Wednesday, 27 January 2010

All hospital patients need a DVT check, say guidelines

By Michelle Roberts
Health reporter, BBC News

Compression stockings to prevent DVT
Stockings and pneumatic compression devices can prevent a clot

All patients admitted to hospital in England, Wales and Northern Ireland should be assessed for the risk of dangerous blood clots, guidance says.

The National Institute for Health and Clinical Excellence is focusing on the risk of clots in veins of the legs, known as deep vein thrombosis (DVT).

An estimated 25,000 people die from the avoidable condition each year.

Ministers said trusts that fail to act on the guidelines are likely to face financial penalties.

Primary Care Trusts could penalise hospitals that fail to screen at least 90% of their patients by withholding a percentage of the value of a contract, which would equate to millions of pounds for the large institutions.

From 1 April, a hospital could stand to lose 0.3% of its income through the new Department of Health commissioning for quality and innovation framework.

CLOT RISK FACTORS
Reduced mobility for three or more days
Surgery
Combined oral contraceptive pill
Infection
Obesity
Pregnancy
Cancer
Heart/circulation problems

According to doctors, prevention is straightforward, involving leg compression stockings plus a small shot of a blood thinning drug for those at high risk.

Chief Medical Officer Sir Liam Donaldson said: "The Department of Health is prioritising the prevention of venous thromboembolism across the NHS.

"I welcome this clear advice from NICE and would expect hospitals to implement it.

"It aims to save lives and reduce risks for patients."

Preventable deaths

DVT can be fatal if the clot breaks off and travels in the blood up to the lungs and causes a blockage, known as a pulmonary embolism.

Certain people admitted to hospital are known to be at very high risk of problems - for example, those who will be bed-ridden for a long time, those undergoing extensive surgery and patients who are very overweight.

But other risk factors that add to this, like dehydration or a women being on the combined contraceptive pill, may not be spotted.

NICE says all adult patients, without exception, should be assessed with a check list on being admitted to hospital.

Professor Tom Treasure: 'There is no special screening or blood tests'

Professor Tom Treasure, chairman of the guideline development group and a professor or cardiothoracic surgery, said: "It is a silent killer - so it is 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."

He said patients should ask for a risk assessment if they are not given one.

The risk of DVT will be set against the chance a patient may suffer internal bleeding, which can occur with some health conditions but is also a side-effect of blood thinning drugs.

Professor Beverley Hunt of the thrombosis charity Lifeblood welcomed the recommendations.

She said: "This is a cost-effective way to save lives. It will only take a doctor or nurse a few minutes to do a risk assessment, based on things like the patient's age and what is wrong with them."



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SEE ALSO
Clot drug 'could save thousands'
20 Apr 08 |  Health
'Pear and apple' shape a DVT risk
29 Oct 09 |  Health
Clot patients 'die unnecessarily'
19 Nov 07 |  Health

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