Academic literature on the topic 'Venous thromboembolism (VTE, DVT, PE)'
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Journal articles on the topic "Venous thromboembolism (VTE, DVT, PE)"
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Schellack, Gustav, Tumelo Modau, and Natalie Schellack. "Clinical overview of venous thromboembolism." South African Family Practice 58, no. 1 (January 1, 2016): 7. http://dx.doi.org/10.4102/safp.v58i1.4373.
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Venous thromboembolism (VTE) encompasses two vascular conditions that are of significant importance, namely deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT is also the most common cause of PE. Medical and surgical patients, and individuals who are at increased risk of developing VTE through a variety of factors, require adequate thromboprophylaxis. Primary and secondary prevention, as well as the definitive treatment of VTE, are accomplished through the use of a variety of anticoagulant drugs. This article attempts to provide an overview of VTE, and its prevention and treatment.
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Kearon, Clive. "Diagnosis of suspected venous thromboembolism." Hematology 2016, no. 1 (December 2, 2016): 397–403. http://dx.doi.org/10.1182/asheducation-2016.1.397.
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Abstract The primary goal of diagnostic testing for venous thromboembolism (VTE) is to identify all patients who could benefit from anticoagulant therapy. Test results that identify patients as having a ≤2% risk of VTE in the next 3 months are judged to exclude deep vein thrombosis (DVT) or pulmonary embolism (PE). Clinical evaluation, with assessment of: (1) clinical pretest probability (CPTP) for VTE; (2) likelihood of important alternative diagnoses; and (3) the probable yield of D-dimer and various imaging tests, guide which tests should be performed. The combination of nonhigh CPTP and negative D-dimer testing excludes DVT or PE in one-third to a half of outpatients. Venous ultrasound of the proximal veins, with or without examination of the distal veins, is the primary imaging test for leg and upper-extremity DVT. If a previous test is not available for comparison, the positive predictive value of ultrasound is low in patients with previous DVT. Computed tomography pulmonary angiography (CTPA) is the primary imaging test for PE and often yields an alternative diagnosis when there is no PE. Ventilation-perfusion scanning is associated with less radiation exposure than CTPA and is preferred in younger patients, particularly during pregnancy. If DVT or PE cannot be “ruled-in” or “ruled-out” by initial diagnostic testing, patients can usually be managed safely by: (1) withholding anticoagulant therapy; and (2) doing serial ultrasound examinations to detect new or extending DVT.
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Spencer, Frederick A., Robert J. Goldberg, Cathy Emery, Darleen Lessard, Apar Bains, Richard C. Becker, and Frederick A. Anderson. "The Worcester Venous Thromboembolism Study: A Population Based Perspective of Venous Thromboembolism Attack Rates." Blood 106, no. 11 (November 16, 2005): 2242. http://dx.doi.org/10.1182/blood.v106.11.2242.2242.
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Abstract Background: Although increasingly recognized as a major clinical problem, most reported estimates of the attack rates of venous thromboembolism (VTE) are based on studies enrolling patients more than a decade ago. Given changes in patient characteristics, risk factor profiles, and prophylaxis strategies over time, more current estimates are needed if we are to better target high-risk patients and allocate limited health care resources. The purpose of this study was to describe crude, as well as age and gender adjusted, attack rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) in residents of the Worcester Statistical Metropolitan Area (SMSA) during the year 1999. Methods: The medical records of all male and female residents from the Worcester SMSA (2000 census = 478,000) diagnosed with ICD-9 codes consistent with possible DVT and/or PE at all 11 greater Worcester hospital during 1999 were reviewed by trained data abstractors. Characterization of each case of VTE was classified as definite, probable, or possible using prespecified criteria. For purposes of this analysis we approximated attack rates for the total Worcester SMSA population. However, for several specific analyses we have excluded 15 cases of validated VTE occurring in patients < 25 years of age. Age and sex-specific attack rates were calculated in a standard manner. Attack estimates were based on 2000 Massachusetts Census data for the Worcester SMSA which reported 287,631 residents 25 years of age or older. Results: There were a total of 590 recognized episodes of VTE in residents of the Worcester SMSA yielding an approximate attack rate of 123/100,000 population. Approximately one quarter of patients developed VTE during hospitalization for another indication while the remaining three quarters presented to the hospital with VTE. Excluding 15 cases of VTE occurring in patients < 25 years of age yields an attack rate of 200 per 100,000 population (95% C.I. 184, 216). Our study sample included 420 cases of isolated DVT (146/100,000 population), 140 cases of PE with or without DVT (49/100,000 population), and 74 cases of recurrent DVT (26/100,000 population). Overall, attack rates of DVT and PE for females were similar to those of men (DVT 152/100,000 vs 139/100,000; PE 51/100,000 vs 45/100,000). However attack rates in females age 75 years and older were significantly greater than those in men of the same age. The age and specific attack rates of clinically recognized VTE are shown in Figure 1. Conclusions: The annual overall attack rate of VTE in this community based study was slightly higher than that reported in the initial Worcester DVT study of 1985/1986 (107/100,000). In addition, if one excludes the small number of cases of VTE occurring in the young, attack rates/100,000 are almost doubled and increase rapidly with age particularly in women. These data have important implications for targeting of VTE prophylaxis and utilization of health care resources. Attack rate of clinical recognized VTE per 100,000 population: The Worcester Venous Thromboembolism Study 1999 Attack rate of clinical recognized VTE per 100,000 population: The Worcester Venous Thromboembolism Study 1999
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Okumus, Gulfer, Esen Kiyan, Orhan Arseven, Levent Tabak, Reyhan Diz-Kucukkaya, Yesim Unlucerci, Neslihan Abaci, Nihan Erginel Ünaltuna, and Halim Issever. "Hereditary Thrombophilic Risk Factors and Venous Thromboembolism in Istanbul, Turkey: The Role in Different Clinical Manifestations of Venous Thromboembolism." Clinical and Applied Thrombosis/Hemostasis 14, no. 2 (April 2008): 168–73. http://dx.doi.org/10.1177/1076029607305620.
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The aim of this study was to investigate the hereditary thrombophilic risk factors in patients with venous thromboembolism (VTE) and whether these risk factors play a different role in patients with isolated pulmonary embolism (PE) as compared with patients with deep vein thrombosis (DVT) and patients with PE + DVT. The protein C (PC), protein S, antithrombin activities, homocysteine levels, and factor V Leiden (FVL) G1691A and prothrombin G20210A mutations were evaluated in 191 patients with VTE and 191 controls. The prevalence of FVL and PC deficiency were higher in patients ( P = .003 and P = .02, respectively). There was no significant difference for the other risk factors. The combination of thrombophilic risk factors was significantly higher in patients with DVT + PE as compared with patients with isolated PE or DVT ( P = .04). In conclusion, the most important hereditary risk factors for VTE in this study were the FVL mutation and PC deficiency.
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Lim, Wendy, Grégoire Le Gal, Shannon M. Bates, Marc Righini, Linda B. Haramati, Eddy Lang, Jeffrey A. Kline, et al. "American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism." Blood Advances 2, no. 22 (November 27, 2018): 3226–56. http://dx.doi.org/10.1182/bloodadvances.2018024828.
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AbstractBackground:Modern diagnostic strategies for venous thromboembolism (VTE) incorporate pretest probability (PTP; prevalence) assessment. The ability of diagnostic tests to correctly identify or exclude VTE is influenced by VTE prevalence and test accuracy characteristics.Objective:These evidence-based guidelines are intended to support patients, clinicians, and health care professionals in VTE diagnosis. Diagnostic strategies were evaluated for pulmonary embolism (PE), deep vein thrombosis (DVT) of the lower and upper extremity, and recurrent VTE.Methods:The American Society of Hematology (ASH) formed a multidisciplinary panel including patient representatives. The McMaster University GRADE Centre completed systematic reviews up to 1 October 2017. The panel prioritized questions and outcomes and used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess evidence and make recommendations. Test accuracy estimates and VTE population prevalence were used to model expected outcomes in diagnostic pathways. Where modeling was not feasible, management and accuracy studies were used to formulate recommendations.Results:Ten recommendations are presented, by PTP for patients with suspected PE and lower extremity DVT, and for recurrent VTE and upper extremity DVT.Conclusions:For patients at low (unlikely) VTE risk, using D-dimer as the initial test reduces the need for diagnostic imaging. For patients at high (likely) VTE risk, imaging is warranted. For PE diagnosis, ventilation-perfusion scanning and computed tomography pulmonary angiography are the most validated tests, whereas lower or upper extremity DVT diagnosis uses ultrasonography. Research is needed on new diagnostic modalities and to validate clinical decision rules for patients with suspected recurrent VTE.
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Bishop, Meghan, Matthew Astolfi, Eric Padegimas, Peter DeLuca, and Sommer Hammoud. "Venous Thromboembolism Within Professional American Sport Leagues." Orthopaedic Journal of Sports Medicine 5, no. 12 (December 1, 2017): 232596711774553. http://dx.doi.org/10.1177/2325967117745530.
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Background: Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes. Purpose: To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes. Study Design: Descriptive epidemiology study. Methods: An online search of all team injury and media reports of DVT/PE in NHL, MLB, NBA, and NFL players available for public record was conducted by use of Google, PubMed, and SPORTDiscus. Searches were conducted using the professional team name combined with blood clot, pulmonary embolism, and deep vein thrombosis. Results: A total of 55 venous thromboembolism (VTE) events were identified from 1999 through 2016 (NHL, n = 22; MLB, n = 16; NFL, n = 12; NBA, n = 5). Nineteen athletes were reported to have an upper extremity DVT, 15 had a lower extremity DVT, 15 had a PE, and 6 had DVT with PE. Six athletes sustained more than 1 VTE. The mean age at time of VTE was 29.3 years (range, 19-42 years). Mean (±SD) time lost from play was 6.7 ± 4.9 months (range, 3 days to career end). Seven athletes did not return to play. Players with upper extremity DVT had a faster return to play (mean ± SD, 4.3 ± 2.7 months) than those with lower extremity DVT (5.9 ± 3.8 months), PE (10.8 ± 6.8 months), or DVT with PE (8.2 ± 2.6 months) ( F = 5.69, P = .002). No significant difference was found regarding time of return to play between sports. Conclusion: VTE in professional athletes led to an average of 6.7 months lost from play. The majority of athletes were able to return to play after a period of anticoagulation or surgery. Those with an upper extremity DVT returned to play faster than those with other types of VTE. Further study is needed to look into modifiable risk factors for these events and to establish treatment and return-to-play guidelines to ensure the safety of these athletes.
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Weitz, Jeffrey I., and Noel C. Chan. "Novel antithrombotic strategies for treatment of venous thromboembolism." Blood 135, no. 5 (January 30, 2020): 351–59. http://dx.doi.org/10.1182/blood.2019000919.
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Abstract Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cause of vascular death after heart attack and stroke. Anticoagulation therapy is the cornerstone of VTE treatment. Despite such therapy, up to 50% of patients with DVT develop postthrombotic syndrome, and up to 4% of patients with PE develop chronic thromboembolic pulmonary hypertension. Therefore, better therapies are needed. Although direct oral anticoagulants are more convenient and safer than warfarin for VTE treatment, bleeding remains the major side effect, particularly in cancer patients. Factor XII and factor XI have emerged as targets for new anticoagulants that may be safer. To reduce the complications of VTE, attenuation of thrombin activatable fibrinolysis inhibitor activity is under investigation in PE patients to enhance endogenous fibrinolysis, whereas blockade of leukocyte interaction with the vessel wall is being studied to reduce the inflammation that contributes to postthrombotic syndrome in DVT patients. Focusing on these novel antithrombotic strategies, this article explains why safer anticoagulants are needed, provides the rationale for factor XII and XI as targets for such agents, reviews the data on the factor XII– and factor XI–directed anticoagulants under development, describes novel therapies to enhance fibrinolysis and decrease inflammation in PE and DVT patients, respectively, and offers insights into the opportunities for these novel VTE therapies.
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Rai, Manoj P., Prabhjot Singh Bedi, Justin D. Kaner, Samanjit Kaur Kandola, Konchok Norgais, Nishant Tageja, Heather Laird-Fick, James B. Bussel, Stanley M. Marks, and Marwan S. Abougergi. "Venous Thromboembolism (VTE) in Hematological and Non-Hematological Cancers: A Nationwide Analysis." Blood 132, Supplement 1 (November 29, 2018): 3563. http://dx.doi.org/10.1182/blood-2018-99-115839.
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Abstract Introduction: Cancer patients tend to have a higher incidence of venous thromboembolism (VTE) - pulmonary embolism (PE) and deep venous thrombosis (DVT). There is conflicting data in the literature about the incidence of VTE in solid tumors versus hematological cancers. The purpose of this study was to analyze the prevalence of PE, DVT, and VTE in hospitalized patients with solid and hematologic malignancies using the National Inpatient Sample database. Methods: We performed a retrospective cohort analysis of the National Inpatient Sample 2014 Database (HCUP-NIS). Patients were included in the study if they had a principal diagnosis of DVT, PE, or both (VTE); primary or secondary diagnosis of solid tumors or hematological malignancy; and age 18 years or older. We performed univariate and multivariate regression to analyze the association of PE, DVT, and VTE with solid versus hematologic cancers. We performed univariate and multivariate regression to determine their statistical significance. We also performed univariate analysis for tumor type and saddle PE and upper extremity DVT. All analyses applied the HCUP-NIS weights. Results: We identified 27,410 patients with isolated DVT; 41,645 with isolated PE; and 69,055 with both DVT and PE (VTE). On multivariate analysis, hematologic malignancy had lower odds of DVT (OR 0.82, 95% CI 0.75-0.89), isolated PE (OR 0.65, 95% CI 0.60 - 0.71) and VTE (OR 0.72, 95% CI 0.67-0.76). Female sex and Charlson index were associated with modest increased odds of DVT, PE and VTE (OR <1.10 for all), while Asian/Pacific Islander race was associated with lower odds for each (OR 0.48-0.55). In contrast, black race was associated with greater odds of DVT (OR 1.49, 95% CI 1.37-1.62) and VTE (OR 1.27, 95% CI 1.2-1.34), but lower odds of isolated PE (OR 0.48, 95% CI 0.38-0.59). Native American and other race had lower odds of VTE (OR 1.27, 95% CI 1.2-1.34 and OR 0.82, 95% CI 0.71-0.95, respectively). Hispanic ethnicity had lower odds of PE (OR 0.66, 95% CI 0.59-0.73) and VTE (OR 0.76, 95% CI 0.70-0.82). Although, 91.1% of patients with malignancy and saddle PE had solid tumors, tumor type (solid versus hematological) was not statistically significant on univariate regression analysis (OR 0.83, 95% CI 0.58-1.18). Hematologic malignancy was associated with less upper extremity DVT (OR 0.69, 95% CI 0.54-0.88). Discussion: Based on the above data, patients with solid tumors are more likely to develop isolated DVT, PE, VTE, and upper extremity DVT. The analysis was likely underpowered to identify a difference for saddle PE, a relatively rare event with high mortality. Race appears to be associated in complex ways. In particular, it is unclear why black patients have increased odds of developing DVT or VTE, but lower odds for isolated PE. Two possible explanations are differences in health seeking behavior or increased outpatient mortality for isolated PE. As with saddle PE, it's likely the sample was too small to find differences for isolated DVT or PE for Native Americans and others. Additional studies to examine the reasons for differences by tumor type and race/ethnicity are needed. Table. Table. Disclosures Bussel: Rigel: Consultancy, Research Funding; Amgen Inc.: Consultancy, Research Funding; Protalex: Consultancy; Novartis: Consultancy, Research Funding; Momenta: Consultancy; Uptodate: Honoraria; Prophylix: Consultancy, Research Funding. Marks:Seattle Genetics: Equity Ownership; Heron: Membership on an entity's Board of Directors or advisory committees; Lilly: Membership on an entity's Board of Directors or advisory committees; Odonate: Membership on an entity's Board of Directors or advisory committees; UPMC: Employment.
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Lex, Johnathan R., Scott Evans, Paul Cool, Jonathan Gregory, Robert U. Ashford, Kenneth S. Rankin, Tom Cosker, Amit Kumar, Craig Gerrand, and Jonathan Stevenson. "Venous thromboembolism in orthopaedic oncology." Bone & Joint Journal 102-B, no. 12 (December 1, 2020): 1743–51. http://dx.doi.org/10.1302/0301-620x.102b12.bjj-2019-1136.r3.
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Aims Malignancy and surgery are risk factors for venous thromboembolism (VTE). We undertook a systematic review of the literature concerning the prophylactic management of VTE in orthopaedic oncology patients. Methods MEDLINE (PubMed), EMBASE (Ovid), Cochrane, and CINAHL databases were searched focusing on VTE, deep vein thrombosis (DVT), pulmonary embolism (PE), bleeding, or wound complication rates. Results In all, 17 studies published from 1998 to 2018 met the inclusion criteria for the systematic review. The mean incidence of all VTE events in orthopaedic oncology patients was 10.7% (1.1% to 27.7%). The rate of PE was 2.4% (0.1% to 10.6%) while the rate of lethal PE was 0.6% (0.0% to 4.3%). The overall rate of DVT was 8.8% (1.1% to 22.3%) and the rate of symptomatic DVT was 2.9% (0.0% to 6.2%). From the studies that screened all patients prior to hospital discharge, the rate of asymptomatic DVT was 10.9% (2.0% to 20.2%). The most common risk factors identified for VTE were endoprosthetic replacements, hip and pelvic resections, presence of metastases, surgical procedures taking longer than three hours, and patients having chemotherapy. Mean incidence of VTE with and without chemical prophylaxis was 7.9% (1.1% to 21.8%) and 8.7% (2.0% to 23.4%; p = 0.11), respectively. No difference in the incidence of bleeding or wound complications between prophylaxis groups was reported. Conclusion Current evidence is limited to guide clinicians. It is our consensus opinion, based upon logic and deduction, that all patients be considered for both mechanical and chemical VTE prophylaxis, particularly in high-risk patients (pelvic or hip resections, prosthetic reconstruction, malignant diagnosis, presence of metastases, or surgical procedures longer than three hours). Additionally, the surgeon must determine, in each patient, if the risk of haemorrhage outweighs the risk of VTE. No individual pharmacological agent has been identified as being superior in the prevention of VTE events. Cite this article: Bone Joint J 2020;102-B(12)1743:–1751.
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Veiraiah, A., HGM Shetty, and PA Routledge. "Prevention and treatment of venous thromboembolism in older people." Reviews in Clinical Gerontology 18, no. 3 (August 2008): 219–28. http://dx.doi.org/10.1017/s0959259809002871.
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The incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively called venous thromboembolism (VTE), increases with age and has been reported to be higher in males. The annual incidence rates per 1000 for DVT and PE are 1.3 and 1.8, respectively, for people aged between 65 and 69 years, rising to 2.8 and 3.1, respectively, in those aged between 85 and 89 years. Older people are about eight times more likely to develop VTE in hospitals, nursing homes or other chronic care facilities than younger adults. About 1.7% develop PE within one year of treatment for DVT, whilst the one year recurrence rate for PE was 8.0%. About 3% of patients with DVT and 21% of those with PE die in hospital. One year mortality with DVT is 21% and that with PE is 39%.
Dissertations / Theses on the topic "Venous thromboembolism (VTE, DVT, PE)"
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Crawford, Yupin. "The cost-effectiveness of current practice of venous thromboembolism prophylaxis as compared to no prophylaxis or pharmaceuticals only prophylaxis." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/120279/1/Yupin_Crawford_Thesis.pdf.
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This research uses economic evaluation methods to model the current practice of VTE prevention at the Gold Coast Hospital and Health Services compared to historical controls. Additionally the research tested the hypothesis that improved prescribing compliance would achieve better clinical outcomes and would be cost effective. This research revealed that current VTE prophylaxis practice were cost effective as compared to either no or suboptimal prevention. Economic modeling revealed that increasing prescribing compliance to 95% to achieve a lower incidence of DVT and PE was cost effective for General Surgical and Orthopaedic patients. For Medical Patients a blanket prescribing approach was not cost effective.
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Gaston, Sherryl. "Venous thromboembolism (VTE) risk assessment and prophylaxis: a comprehensive systematic review of the facilitators and barriers to healthcare worker compliance with clinical practice guidelines in the acute care setting." Thesis, 2013. http://hdl.handle.net/2440/82715.
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Background: Even though guidelines for venous thromboembolism (VTE) risk assessment and prophylaxis are available, patients with identifiable risk factors admitted to acute hospitals are not receiving appropriate prophylaxis. The incidence of VTE in hospitalised patients is higher than that of people living in the community who have similar demographics. Knowledge of barriers to clinician compliance with clinical practice guidelines and facilitators to improve compliance will aid appropriate use of VTE clinical practice guidelines. Objectives: The objective of this review was to identify the barriers and facilitators to healthcare professional compliance with clinical practice guidelines for VTE assessment and prophylaxis. Inclusion criteria Types of participants: Studies were considered for inclusion regardless of the designation of the healthcare professional involved in the acute care setting. Focus of the review: The focus of the review was compliance with VTE clinical practice guidelines and identified facilitators and barriers to clinical use of these guidelines in the acute care setting. Types of studies: Any experimental, observational studies or qualitative research studies evaluating healthcare professional compliance with clinical practice guidelines were considered for inclusion in this review. Types of outcomes: The outcomes of interest were percentage of compliance with VTE guidelines and identified barriers and facilitators to that compliance. Search strategy: A comprehensive, three-step search strategy was conducted for studies published from May 2003 to November 2011 due to a previous systematic review that overlaps this one, and aimed to identify both published and unpublished studies in the English language across six major databases (PubMed/MEDLINE, CINAHL, EMBASE, Scopus, ProQuest & MedNar).
Methodological quality: Retrieved papers were assessed by two independent reviewers prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute. The critical appraisal tools used were MAStARI for the quantitative studies and QARI for the qualitative studies. There were no disagreements between the two reviewers. Data collection: Both quantitative and qualitative data was extracted from included papers using the standardised data extraction tools MAStARI and QARI from the Joanna Briggs Institute. Data synthesis: Quantitative data was pooled using narrative summary due to heterogeneity in the ways in which data was reported, using quasi-experimental pre and post studies, cohort study and descriptive/case series. Qualitative data was pooled using Joanna Briggs Institute QARI data synthesis tool. Results: In total, twenty studies were included in the review, eighteen quantitative and two qualitative with methodological quality ranging from low to high using the Joanna Briggs Institute appraisal tools MAStARI and QARI. The lowest and highest reported compliance in the quantitative studies at baseline ranged from 6.25% to 70.4% and compliance post intervention ranged from 36% to 100%. Six of the twenty studies included multiple healthcare professionals in the study and of these only one compared the percentage of compliance between the groups. That study acknowledged that due to the variation of improvement between mechanical and pharmacological prophylaxis, and since nursing staff were responsible for mechanical and medical staff for pharmacological that the intervention was more effective for medical staff. Nine main categories of barriers and nine main categories of facilitators to VTE guideline compliance were identified. Similar barriers and facilitators were highlighted by the quantitative and qualitative studies. The studies all had components of education as an intervention and this review found that passive dissemination or a single mode of intervention was not sufficient to affect and sustain change in clinical practice. The main barriers identified were ‘lack of attention’ and lack of awareness’, with the main facilitator being ‘education’. Conclusions: This review identified eighteen quantitative studies and two qualitative studies that assessed compliance with VTE clinical practice guidelines, and identified barriers and facilitators to that compliance. The studies showed that many different forms of intervention can improve compliance with clinical practice guidelines. Interventions can be developed for the specific audience and setting they are being used for, keeping in mind that not all interventions are appropriate for all areas, such as computer applications not being suitable where system capacity is lacking. Implications for practice: Healthcare professionals need to be aware of VTE clinical practice guidelines and improve patient outcomes by using them in the hospital setting. There are a number of interventions that can improve guideline compliance keeping in mind the barriers and adjusting practice to minimise them. Implications for research: Venous thromboembolism compliance within rural hospital settings has not been determined, however as inequalities have been identified in other areas of healthcare between urban and rural regions this would be a logical area to research. Furthermore, the sustainability and cost effectiveness of VTE compliance programs should also be examined.Thesis (M.Clin.Sc.) -- University of Adelaide, School of Translational Health Science, 2013
Books on the topic "Venous thromboembolism (VTE, DVT, PE)"
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Sheares, Karen, and Joanna Pepke-Zaba. Venous thrombosis and pulmonary embolism. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0101.
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Venous thromboembolism (VTE) is a condition in which thrombus forms in a vein, commonly in the deep veins of the leg, termed deep-vein thrombosis (DVT). The thrombus may dislodge from the site of origin and be carried into the pulmonary vasculature, causing a pulmonary embolism (PE). Deep vein thrombosis and pulmonary embolism share similar predisposing factors; however, mortality is greater in those who present with PE than in those who present with DVT. Thrombi may form in other parts of the vasculature.
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Watson, Max, Caroline Lucas, Andrew Hoy, and Jo Wells. Palliative haematological aspects. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199234356.003.0023.
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This chapter on palliative haematological aspects covers anaemia in chronic disorders, blood transfusion, erythropoietin, bleeding and haemorrhage, blood products, bleeding directly related to cancer, haemoptysis, haematemesis, rectal bleeding, haematuria, massive terminal haemorrhage, thromboembolism, deep vein thrombosis (DVT), pulmonary embolism (PE), chronic venous thrombosis, warfarin in patients with cancer, and developing a good relation with haematology colleagues.
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Kahn, S. Lowell. Deploying a Straight Conical Filter. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0053.
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Placement of inferior vena cava (IVC) filters is among the most common medical procedures, with more than 265,000 placed annually. Absolute indications for their placement include acute proximal deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients who have an absolute contraindication to anticoagulation and patients with recurrent thromboembolism despite adequate anticoagulation. Although the survival benefit is unknown, it has been shown that filters decrease the incidence of PE in the short term. Unfortunately, this comes at the expense of known complications, the most important being DVT. This chapter discusses simple techniques to prevent conical filter tilting and enhance retrieval.
Book chapters on the topic "Venous thromboembolism (VTE, DVT, PE)"
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Bashal, Fozya. "Thrombosis in Rheumatological Diseases." In Skills in Rheumatology, 263–89. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-8323-0_12.
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AbstractVenous thromboembolism (VTE) is a disease of blood coagulation that occurs in the veins, most often in the calf veins first, from where it may extend and cause deep vein thrombosis (DVT) or pulmonary embolism (PE). The first described case of venous thrombosis that we know of dates back to the thirteenth century, when deep vein thrombosis was reported in the right leg of a 20-year-old man [1].
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Paje, David G., and Scott Kaatz. "Postoperative Venous Thromboembolism (DVT and PE)." In Perioperative Medicine, 461–71. London: Springer London, 2011. http://dx.doi.org/10.1007/978-0-85729-498-2_38.
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Becker, Richard C., and Frederick A. Spencer. "Venous Thromboembolism Prophylaxis." In Fibrinolytic and Antithrombotic Therapy. Oxford University Press, 2006. http://dx.doi.org/10.1093/oso/9780195155648.003.0030.
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Venous thromboembolism represents a true worldwide medical problem that is encountered within all realms of practice. Venous thromboembolism (VTE) occurs in approximately 100 patients per 100,000 population yearly in the United States and increases exponentially with each decade of life (White, 2003). Approximately one-third of patients with symptomatic deep vein thrombosis (DVT) experience a pulmonary embolism (PE). Death occurs within 1 month in 6% of patients with DVT and 12% of those with PE. Early mortality is associated strongly with presentation as PE, advanced age, malignancy, and underlying cardiovascular disease. An experience dating back several decades has provided a better understanding of disease states and conditions associated with VTE (Anderson and Spencer, 2003). Given the potential morbidity and mortality associated with VTE, it is apparent that prophylaxis represents an important goal in clinical practice. A variety of anticoagulants including unfractionated heparin, low-molecular-weight heparin (LMWH), and warfarin have been studied. More recently, two new agents have been developed that warrant discussion. Fondaparinux underwent a worldwide development program in orthopedic surgery for the prophylaxis of VTE. The program consisted mainly of four large, randomized, double-blind phase II studies comparing fondaparinux (SC), at a dose of 2.5 mg starting 6 hours postoperatively, with the two enoxaparin regimens approved for VTE prophylaxis—40 mg qd or 30 mg twice daily beginning 12 hours postoperatively. The results support a greater protective effect with fondaparinux, yielding a 55.2% relative risk reduction of VTE (Bauer et al., 2001; Eriksson et al., 2001; Lassen et al., 2002; Turpie et al., 2001, 2002; ). A European program of three large-scale clinical trials (MElagatran for THRombin inhibition in Orthopedic surgery [METHRO] I, II, and III, and EXpanded PRophylaxis Evaluation Surgery Study [EXPRESS]) (Eriksson et al., 2002a, b, 2003a, b) evaluated the safety and efficacy of subcutaneous melagatran followed by oral ximelagatran compared with LMWH for thromboprophylaxis following total hip replacement (THR) and total knee replacement (TKR) surgery.
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Nokes, Brandon T., and Rodrigo Cartin-Ceba. "Pulmonary Embolism: An Overview." In Mayo Clinic Critical and Neurocritical Care Board Review, edited by Eelco F. M. Wijdicks, James Y. Findlay, William D. Freeman, and Ayan Sen, 142–49. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190862923.003.0020.
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Venous thromboembolism (VTE) is a major public health concern with an annual incidence of 1 per 1,000 patients in the United States. VTE encompasses a spectrum of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT is a precursor to PE, and approximately 80% of patients have DVT when PE is diagnosed. The risk factors for PE are the same as those for DVT; consequently, diagnosis and management of VTE are contingent on the underlying risk factors and the extent of disease. A suspected VTE diagnosis should be pursued with risk stratification tools such as the Wells DVT and PE criteria and the Revised Geneva Score for PE. This chapter reviews PE diagnosis, risk stratification, and management.
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Becker, Richard C., and Frederick A. Spencer. "Venous Thromboembolism Treatment." In Fibrinolytic and Antithrombotic Therapy. Oxford University Press, 2006. http://dx.doi.org/10.1093/oso/9780195155648.003.0031.
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The potential morbidity and mortality associated with venous thromboembolism (VTE) dictates rapid diagnosis and effective treatment. An understanding of basic anatomy permits a strategic approach to diagnosis and decisions regarding initial therapy. VTE can include the superficial or deep venous systems of the lower (most common) and upper extremities. Because deep vein thrombosis (DVT) of the proximal vessels (iliac, femoral veins) is associated with the greatest risk of pulmonary embolism (PE) (as well as chronic complications such as postphlebitic [thrombotic] syndrome), a proactive response, which may include anticoagulant therapy pending a definitive diagnosis, is recommended. Many DVTs begin in the calf veins and most, in all likelihood, resolve spontaneously. The probability of extension to the popliteal vein or above (where embolism is more likely) is determined by the prothrombotic environment. Proximal thrombi resolve slowly with anticoagulant therapy, and may be detectable in up to 50% of patients 1 year later. Approximately 10% of patients develop postphlebitic syndrome within 5 years—a complication from progressive valvular damage that increases in prevalence with recurrent events (Anderson et al., 1991). Approximately 10% of all PEs are rapidly fatal, and an additional 5% of patients die even after treatment is initiated. Up to 5% of patients develop pulmonary hypertension because of limited thrombus resolution (Kearon, 2003). The diagnosis of DVT and PE is difficult and requires a mixture of clinical suspicion and objective testing. A complete history with attention to specific symptoms and signs should be recorded; a thorough family history is also invaluable. The laboratory evaluation is critical in establishing an unequivocal diagnosis, but most of the tests currently used are not of uniform high sensitivity and specificity. Thus, an accurate diagnosis requires experience and attention to detail. The cardinal symptoms of DVT are pain and swelling in the lower extremity. The pain may be sharp and sudden in onset or come on more gradually and be reported as restricting in character. There may be little or no swelling, or the entire lower extremity may be markedly enlarged. On examination, there is frequently reddish-purple discoloration of the leg in comparison with the noninvolved side.
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Sharma, Gyanendra, and Jaspal Gujral. "Venous Thromboembolism (VTE), Deep Venous Thrombosis (DVT), and Pulmonary Embolism (PE)." In Emergency Medicine, 461. Jaypee Brothers Medical Publishers (P) Ltd., 2005. http://dx.doi.org/10.5005/jp/books/11080_40.
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Hernaningsih, Yetti. "ABO Blood Group and Thromboembolic Diseases." In Blood Groups - More Than Inheritance of Antigenic Substances [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.102757.
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Thromboembolic diseases are usually inherited in the family. The tendency to repeat in an individual is a phenomenon that allows it to be studied. The inheritance and recurrence of thromboembolic diseases, of course, have individual risk factors for this occurrence. In the past, the ABO blood group was only needed for transfusion and organ transplant therapy. Over time, scientists think that blood type is a risk factor for certain diseases, including thromboembolism. Many studies divide between type O and non-O blood groups, both of which are distinguished by the presence of antigens on the cell surface and antibodies in the plasma of individuals. Type O does not have A, B antigens but has antibodies against A, B antigens, and vice versa for the non-O type. Many studies have shown that the non-O blood group has a risk factor for thromboembolic diseases, commonly due to higher levels of von Willebrand factor (VWF) and factor VIII (FVIII). These thromboembolic events can occur in arteries or venous. Thromboembolic manifestations are often associated with cardiovascular diseases for arterial thrombosis; and deep vein thrombosis (DVT) and pulmonary embolism (PE) for venous thromboembolism (VTE).
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"Thrombosis." In Oxford Handbook of Cancer Nursing, edited by Mike Tadman and Dave Roberts, 511–14. Oxford University Press, 2007. http://dx.doi.org/10.1093/med/9780198569244.003.0040.
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Venous thrombosis 512 Venous thromboembolic disease (VTE) includes thrombosis of superficial and deep veins (DVT), usually of the leg, thigh, and pelvis, pulmonary embolus (PE) and thrombosis associated with central venous catheters (CVCs). Venous thrombosis can have a profound impact on a cancer patient's quality of life. It is a well recognized, major complication of cancer and the second leading cause of death in hospitalized patients with cancer. It remains an under-diagnosed and under-treated condition....
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"11 Venous Thromboembolism (DVT and PE): Prophylaxis." In Handbook of Bleeding and Coagulation for Neurosurgery, edited by Mark G. Hamilton, John G. Golfinos, Graham F. Pineo, and William T. Couldwell. Stuttgart: Georg Thieme Verlag, 2015. http://dx.doi.org/10.1055/b-0035-120857.
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Prats, Michael I., David P. Bahner, Creagh T. Boulger, and Michael R. Go. "Deep Venous Thrombosis and Venous Thromboembolism." In Emergency and Clinical Ultrasound Board Review, 392–420. Oxford University PressNew York, 2020. http://dx.doi.org/10.1093/med/9780190696825.003.0015.
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Abstract Venous thromboembolic disease is often a concern for those presenting to the acute care setting. Whether it be a deep venous thrombosis (DVT) or a pulmonary embolism (PE), point-of-care ultrasound (POCUS) can be helpful in the diagnosis and management of these patients. For DVTs, duplex sonography is considered the standard for diagnosis, and studies have shown that POCUS can accurately and quickly make this diagnosis. In addition to ultrasound of the veins, POCUS of the lungs and heart can assist in diagnosing PE. Furthermore, the diagnosis of right heart strain on point-of-care echocardiography can assist with risk stratification of patients with the diagnosis of PE. Overall, POCUS is a valuable modality that can assist in the timely management of this potentially life-threatening disease.
Conference papers on the topic "Venous thromboembolism (VTE, DVT, PE)"
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Bolland, Matthew J., Brian J. Robinson, Lester Rivett, Lynne Robson, Patrick J. Kesteven, and A. J. Simpson. "Pulmonary Embolism (PE) Precipitated By A Clear Transient Risk Factor Is Associated With A High Rate Of Recurrent Venous Thromboembolism (VTE)." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a2362.
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Poniewierski, M., M. Barthels, and H. Poliwoda. "THE SAFETY AND EFFICACY OF A LOW MOLECULAR WEIGHT HEPARIN (FRAGMIN) IN THE PREVENTION OF DEEP VEIN THROMBOSIS IN MEDICAL PATIENTS: A RANDOMIZED DOUBLE-BLIND TRIAL." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643224.
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The safety and efficacy of 2500 anti-Factor Xa U of a low molecular weight heparin (Kabi 2165, Fragmin) subcutaneously once a day, and 5000 IU of standard unfractionated Heparin (KabiVitrum, Stockholm) subcutaneously twice daily as thromboprophylaxis was compared in 200 medical patients in a randomized double blind trial. According to the risk of DVT the patients were stratified before randomization in a high and low risk group. The high risk group consisted of 100 patients mainly with malignant diseases and/or previous history of thromboembolism, the low risk group of 100 patients with mainly myocardial infarction and/or coronary heart disease. The prophylaxis was given for seven to ten days. In 192 consecutive patients the clinical status and thermographic screening for DVT (leg temperature profiles, DeVeTherm) were daily evaluated. In two cases of suspected DVT and one case of suspected PE, the following phlebography or pulmonary scintigraphy were found to be negative. In the high risk group, one patient treated with Fragmin having a central venous catheter developed on day 10 symptoms of an arm vein thrombosis. There were no bleeding complications observed in either of the two treatment groups. Two patients with trombocytopenia (25.000 and 22.000/pl) due to chemotherapy and underlying malignant disease were successfully treated with Fragmin without developing any bleeding complications. In eight patients during Fragmin prophylaxis invasive diagnostic methods as heart catheterization, gastroscopy, bronchoscopy or spinal puncture were performed without noticing any bleeding events. 2500 anti-Factor Xa U of Fragmin gave plasma levels by anti-Factor Xa assay (S-2222, Kabi) of mean 0,1 U/ml when blood was sampled three to four hours after the subcutaneus application. There was no accumulation during the treatment periode observed.This study suggests that 2500 anti-Factor Xa U of Fragmin once daily is as safe and effective as 5000 IU of standard heparin twice daily in these medical patients. Especially in patients who need prophylaxis for a long time eg. with malignant disease, the once daily injection is welcomed.
Reports on the topic "Venous thromboembolism (VTE, DVT, PE)"
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hou, xianbing, dandan chen, tongfei cheng, dan wang, xiaojun dai, yao wang, bixian cui, et al. Bleeding risk of anticoagulant therapy in patients with advanced cancer in palliative care settings：a protocol for systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0064.
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Review question / Objective: The systematic review aim to provide synthesised and appraised evidence to assess the bleeding risk of anticoagulant therapy in patients with advanced cancer in palliative care settings. Condition being studied: Cancer is a recognized risk factor for venous thromboembolism (VTE). The main forms of thromboembolic disease include pulmonary embolism (PE) and deep vein thrombosis (DVT). Given their diagnosis and often poor physical status, patients with advanced cancer are at particularly high risk of developing VTE, resulting in reduced activity levels or even immobility. The exact incidence and prevalence of VTE in the population of cancer patients receiving hospice or palliative care has not been well investigated and few reports are available. Clinical studies have not yet determined whether such patients benefit from anticoagulant therapy and whether there is an increased risk of bleeding and death.