Thousands of hospital patients are dying
unnecessarily of blood clots every year, says a report by
Clots can lodge in the lungs
Clots kill more than 25,000 in England each year, yet
many doctors are unaware and will not get clear prevention
guidelines until May 2007, it claims.
As well as being too late, the guidance will not do
enough to protect patients, the Commons health committee
The Department of Health said it commissioned the
guidelines because practice varied between hospitals.
The report looked at what was being done to prevent
hospital patients in England getting dangerous blood clots
called venous thromboembolisms (VTEs).
These include clots in the leg veins, called deep vein
thromboses (DVTs), which can break off and lodge in the
small vessels in the lung.
If this occurs the condition is called a pulmonary
embolism, which is fatal in about a third of cases without
Pulmonary embolism following DVT kills more than breast
cancer, Aids and traffic accidents combined, and 25 times
more people than the superbug MRSA.
Many of these deaths are preventable with blood-thinning
drugs and simple measures such as stretching exercises and
Yet hospital staff are not aware of the extent of the
problem and there are no national guidelines to help them,
says the House of Commons Health Committee.
The Government asked the National Institute for Clinical
Excellence (NICE) to look at the problem and report back in
Health Committee chairman David Hinchliffe said: "I find
it shocking that this has been allowed to go unchecked for
"The guidelines which the NHS plan to introduce in May
2007 are too late, too narrow in scope and will not go far
enough to prevent more unnecessary deaths."
The committee says all hospital patients should be
assessed and given preventive treatment against clots,
rather than just those about to undergo surgery who are
known to be particularly high risk, as will be recommended
in the 2007 guidelines.
VTE RISK FACTORS
Pregnancy and the oral contraceptive pill
Diseases like cancer that affect clotting
Blood disorders that affect clotting
Long distance air travel
Each hospital should also create a 'thrombosis team' as
soon as possible, which would be charged with the
responsibility of educating staff and making sure guidelines
are followed, it advises.
Another problem, says the committee, is that many
patients who develop clots show signs that something is
wrong only after they have been discharged from hospitals.
This means the doctor who treated the patient in hospital
is often not informed that their patient had a VTE.
Dr David Keeling, who gave advice to the committee on
behalf of the Royal College of Physicians, said many medics
concentrated on treating surgical patients and forgot about
medical patients, who are "also at risk".
Conservative Shadow Health Secretary Andrew Lansley said:
"This report highlights where further progress can, and must
be made, in improving NHS services.
"The next Conservative government will ensure the NHS has
the resources, freedoms and standards to enable that to
A Department of Health spokeswoman said they asked NICE
to look draw up guidelines because practice varies widely
She said data showed about four out of 10 orthopaedic
patients did not receive any form of preventative treatment
against blood clots.
But she said: "No one is waiting around until 2007.
"There is currently a variety of treatment options
available for people with VTE. Patients should discuss these
with their clinicians."