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Hospital Patients' Blood Clot Risk High
Date:1/31/2008

t), Thailand (4 percent) and Romania (18 percent) at the bottom.

In the United States, 48 percent of at-risk medical patients received the appropriate care.

Germany scored the highest for at-risk surgical patients (92 percent), along with Hungary (87 percent) and Spain (82 percent). Bangladesh and Thailand (both 0.2 percent) were the low rankers again, along with Pakistan (10 percent). In this category, the United States scored 71 percent.

VTE can result in blockage of blood vessels in the leg (deep vein thrombosis) or a pulmonary embolism, the blockage of a lung artery that can sometimes be fatal.

VTE is common during and after hospitalization, and is considered the most common preventable cause of in-hospital death. Studies have linked pulmonary embolism to up to 10 percent of in-hospital sudden deaths.

Guidelines for prevention of VTE in hospitals have been available for more than 15 years, yet are underused. Such treatments include blood-thinning drugs, as well as pneumatic compression and compression stockings.

According to an accompanying commentary in the journal, preventive medications can reduce the risk of pulmonary embolism by 75 percent in general surgical patients and by 57 percent in medical patients.

One U.S. expert agreed that steps can be taken to reduce the danger to patients. Dr. Joel Horovitz, director of the division of general surgery at Maimonides Medical Center in New York City, noted that some hospitals are using a computer-order entry system in which all hospital orders have to be recorded on the computer, not written.

"At our hospital, doctors can't escape that screen, so 97 percent of patients admitted to surgery are prescribed prophylaxis," he said.

But a recent study of U.S. hospital patients found that, despite these guidelines, half the patients were not getting preventive treatment for VTE.

"Identifying those at risk of developing a
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