Maximising prevention methods for venous thromboembolism (VTE) will improve patient outcomes, save lives and reduce health costs, according to an editorial in the latest issue of the Medical Journal of Australia.
Australian Institute of Health and Welfare data indicate that seven per cent of all hospital deaths are due to VTE - deep vein thrombosis (DVT) or pulmonary embolism (PE) - and autopsy studies suggest the percentage may even be as high as ten per cent.
Professor Beng Chong, Director of the Haematology Department at St George Hospital, and his co-authors believe the incidence of VTE in the Australian population comes with high costs to society in terms of deaths, morbidity and health care expenditure.
"Doctors, nurses, health administrators and governments should work together to ensure all surgical and medically ill patients in hospital have their VTE and bleeding risk assessed," he said.
"VTE prophylaxis is effective and safe, but grossly underused in Australian hospitals."
In a research paper in the same issue of the Medical Journal of Australia
, Dr Wai Khoon Ho, a haematologist from the Austin and Repatriation Medical Centre in Melbourne and his co-authors said VTE was one of the most common preventable causes of in-hospital deaths.
In the first population-based prospective study of the incidence of VTE in Australia, the authors estimated that VTE affected about 17,000 Australians per annum.
However, it is likely that the results underestimated the true burden of the disease. Dr Ho said symptomatic VTE could be misdiagnosed for other medical conditions.
"Cultural, financial, social and educational factors may also influence patients' perception and interpretation of symptoms and their willingness to seek medical attention," he said.
The authors studied VTE incidence in north-eastern metropolitan Perth over a 13-month period to October 2004. One hundred and thirty-seven patients had 140 VTE events - 87 DVT and 53 PE events. The crude annual incidence was 0.83 per 1,000 residents.
Consistent with other community-based incidence studies, the research found that VTE rates increased with age. The mean age of patients with VTE was 64.6 years.
Dr Ho said that knowing the local incidence should allow Australian health planners to allocate clinical and social services accordingly, and to perform appropriate pharmacoeconomic evaluations of management and preventive strategies.
"Future studies of trends in VTE incidence will be needed to measure the effectiveness of VTE prevention strategies," he said.
The Medical Journal of Australia
is a publication of the Australian Medical Association.