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Blood clots: preventing the “little known killer” in hospitals

Blood clots kill four times more Australians than car accidents – and not enough is being done to curb them in hospital settings.

That’s why the Australian Commission on Safety and Quality in Health Care (the Commission) released a new nationally agreed standard of care.

The Commission said blood clots, also known as venous thromboembolism (VTE), account for an estimated 10 per cent of all hospital deaths in Australia  – an estimated 5,000 people die each year as a result of hospital-acquired VTE.

Yet, the body added, they are largely preventable with intervention reducing the incidence of VTE by up to 70 per cent for both medical and surgical patients.

Associate Professor Amanda Walker, clinical director at the Commission, said it’s concerning that a recent Australian report found that fewer than half (44 per cent) of clinical units surveyed assessed patients for their risk of developing VTE on admission to hospital.

“Of those who were assessed to be at risk, not all were offered VTE prevention,” Walker said. “This clearly indicates that many patients who should be receiving preventative treatment for blood clots are not getting the care they need.”

Dr Sally Cockburn, a GP and health advocate, said the system needs to change so that fewer people die unnecessarily.

Cockburn added often people don’t know what to look out for.

“Many people don’t realise they have a blood clot in a vein,” she said. “It may not be until after a clot breaks off and the blood supply to the lungs becomes blocked that signs are noticed.”

Cockburn had her own experience with this. She suddenly collapsed at home when a clot in a vein moved to block her lung causing a pulmonary embolism.

“Mine was a close brush with death and I want others to learn the warning signs.”

Walker said the new standard offers guidance on appropriate blood clot prevention methods and the importance of ongoing care after the patient leaves hospital.

“We know that up to 60 per cent of all VTE cases in Australia occur within 90 days of hospitalisation, and it can happen to both medical and surgical patients.

“We can do better and the new standard aims to support clinicians and health services to deliver quality care to prevent blood clots in hospital and following discharge,” she said. “In fact, the evidence suggests that appropriate use of VTE prevention methods is the top intervention hospitals can make to improve patient safety.”

Leading haematologist Associate Professor Huyen Tran, based at the Alfred Hospital, said blood clots can be significantly reduced through timely assessments that are documented and discussed with the patient, and appropriate use of prevention methods such as medicine, during and after discharge from hospital.

“It is shocking to consider that patients who have been admitted to hospital are at 100 times greater risk of developing a blood clot,” Tran said. “This is a little known killer but one of the biggest preventable health threats facing Australians.”

There are signs that can point to blood clot risk, Tran added, such as symptoms like pain, tenderness or swelling of the leg, shortness of breath, coughing up blood or chest pain after a hospital stay.

“Improved uptake of appropriate clot prevention strategies will help reduce the impact – on both patients and the health system.”

The Venous Thromboembolism Prevention Clinical Care Standard and fact sheets for consumers and clinicians can be found on the Commission’s website.

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