Harvard Heart Letter

Heart Beat: Blood clot prevention lacking in hospitals

Most of the things that happen in hospitals are necessary and good. A few, like infection and medication mistakes, aren't. A lesser known but equally serious hazard is venous thromboembolism (VTE) — the formation of a blood clot in a vein. The immobility and stress of hospitalization conspire to make blood more likely to clot. Old age, injury, cancer, obesity, and smoking also contribute to the problem.

If the clot stays in the vein in which it forms, it can cause a painful, vein-damaging deep-vein thrombosis. If it breaks away and travels to the lungs, it can cause a pulmonary embolism, which can be deadly. Each year, more than 200,000 Americans die from a hospitalization-related blood clot.

Most folks who are relatively healthy need to do little more than get out of their hospital beds and walk around to prevent VTE. Those who are confined to bed, are having surgery, or are at risk for VTE need stronger medicine, such as heparin or warfarin. But studies from the University of California, Irvine, indicate that only about 15% of hospital patients get the anticoagulation therapy they need (Journal of Hospital Medicine, October 2009, and annual meeting of the American Society of Hematology, December 2009).

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