Venous Thrombo-Embolism is considered one of the highest risk for hospitalized and community patients. The in hospital case fatality rate of VTE ranged between 10 – 12 %. Around 10 % of hospital deaths are due to PE, and 1 % of all hospital admissions died from PE.
In the literature, 60 – 70 % of DVT cases were clinically undiagnosed and only detected at autopsy. At least 70 % of fatal PE detected post mortem was neither suspected nor diagnosed pre mortem. PE is the most common preventable cause of hospital deaths.
Appropriate use of prophylaxis for VTE in patients at risk is the number one strategy to improve patient safety in the hospitals. Therefore, appropriate use of thromboprophylaxis should reduce adverse patient outcome and decrease overall cost.
All hospitalized patients, 14 years and above should be screened and assessed for their venous thrombo embolic risk and should receive subsequent prophylaxis. Early ambulation should be considered for all patients as soon as the clinical condition permits.
For each of pharmacologic agents, clinician should consider the manufacturer’s suggested dosing guidelines. For each patient, the benefits of starting pharmacologic prophylaxis should be weighed against the risk of bleeding. Mechanical methods (Intermittent Pneumatic Compression and/or Graduated Compression Stockings (GCS)) of prophylaxis should be used primarily in patients who are at high risk of bleeding or as an adjunct to pharmacologic prophylaxis.
Fahad M Al-Hameed, MD, AmBIM, FCCP, FRCPC
Consultant Critical Care & Pulmonary Medicine
Deputy Chairman of Intensive Care Department
Chairman of Saudi Association for Venous-Thrombo-Embolism (SAVTE)
King Khalid National Guard Hospital
King Abdulaziz Medical City
Kingdom of Saudi Arabia