A national initiative to carry out mandatory screening of hospital patients for deep vein thrombosis has resulted in a significant reduction in death rates, experts in Birmingham have concluded.
A major study was carried out involving every single patient admitted to all 163 NHS hospital Trusts in England between July 2010 and March 2012. The team from the Quality and Outcomes Research Unit (QUORU) of University Hospitals Birmingham NHS Foundation Trust, led by Professor Domenico Pagano, sought to check the effectiveness of the venous thromboembolism (VTE) risk screening programme introduced into all NHS hospitals. They have now concluded that if all Trusts achieved the required quality standard, they could expect that 280 deaths from VTE would have been avoided among patients admitted to hospital for more than three days. In addition, a further 150 deaths within 90 days of discharge could have been prevented among patients with hospital admissions of less than four days. Prof. Pagano has presented the findings to the All-Party Parliamentary Thrombosis Group at Westminster. The study, which is published in the journal Heart, followed on from the Department of Health in England’s decision in 2010 to introduce a quality incentive for NHS hospital Trusts to screen at least 90% of admitted patients for the risk of developing VTE. Those hospitals which assessed at least 90% of patient admissions achieved the quality standard. The study concluded that there was a ‘statistically significant reduction’ in VTE deaths in hospitals achieving the risk assessment target, both for surgical and non surgical patients. The published report makes clear that hospital associated VTE is a potentially preventable cause of death and disability, with the relative risk increasing more than 100 fold after hospital admissions for surgical procedures. However, it added that deaths from VTE are often sudden or are misdiagnosed pre-mortem and, therefore, prevention is a key strategy. The results showed that across the 21 months period of the study, on average, hospitals achieved the quality standard risk assessment 56% of the time. But closer analysis revealed a substantial improvement over the time period, from 51% in the first month (July 2010) to 93% in the final month (March 2012).
