Venous Thromboembolism (VTE)
Introduction
Venous thromboembolism (VTE) is a term that describes a condition that occurs when clots or thrombi develop in the vein from red blood cells, fibrin and other components which clump and form a mass. VTE is the result of at least one of three underlying etiologic factors: damage to endothelial lining of the blood vessel, stasis or slowing of the blood flow, and hypercoagulability or increased clotting of the blood.
VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE)
VTE consists of two related conditions: deep vein thrombosis (DVT) that commonly occurs in leg veins, and pulmonary embolism (PE) that occurs when a segment of a clot, within the deep venous system detaches from the vessel, travels to the lungs, and lodges within the pulmonary arteries.
Incidence – morbidity and mortality
It is estimated that more than 900,000 Americans develop DVT each year, and 500,000 of these persons develop PE with 30 percent of PEs being fatal. About two-thirds of all VTE events are related to hospitalization. The National Quality Forum’s (NQF) “Safe Practices for Better Healthcare – 2006 Update” reports that VTE is the third most common cause of hospital-related deaths in the United States and the most common preventable cause of hospital death.
Risks factors for VTE
The specific type and duration of prophylaxis to prevent VTE will depend on the individual risk factor (see Table) or combination of risk factors.
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Risk factors for VTE |
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Prevention
Several clinical interventions are recommended for the prevention of VTE. These include 1) anticoagulation drug therapy, including heparin, factor Xa inhibitors, and Vitamin K inhibitors (e.g., warfarin); and mechanical interventions, such as intermittent leg compression devices and graduated compression stockings. See resources for prevention.