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Deep Vein Thrombosis: A Silent Killer

Mar 18, 2008 10:00 AM

It’s a distinct feeling, unlike any other pain I’ve ever had,” says Walter McPhie, describing the sensation associated with deep vein thrombosis (DVT). "It’s as if there is electricity in it.”

DVT occurs when a thrombus (a blood clot) forms in one of the large veins, usually in the legs or feet. Some of these gelatin-like clots anchor themselves to a vein wall, inhibiting circulation, but other clots that are not anchored down or are somehow jarred loose will start traveling upward toward the lungs and cause a deadly pulmonary embolism (PE).

McPhie, a former marathoner and University professor, has experienced three such blood clots, the first two lodging in his lower left leg and the last clot traveling to his lungs. “I had maybe one or two days left when it was found,” recalls McPhie, who was treated by the newly named University Healthcare Thrombosis Service.

Like most people, McPhie had never heard of the condition before diagnosed with it 25 years ago. Yet, despite this lack of awareness, more than 2  million Americans are affected annually by DVT, and some 300,000 die from the ensuing pulmonary embolism—more than aids and breast cancer deaths combined. Pulmonary embolisms are considered the most common cause of preventable hospital death, with two-thirds of all blood clots occurring in a hospital or surgery setting.

Robert Pendleton, M.D., assistant professor of internal medicine and medical director of the U’s Thrombosis Service, has focused his career on DVT, transforming a typical Coumadin Clinic into a comprehensive program staffed by highly trained nurses, pharmacists, physicians, and support staff and focused on treatment, prevention, clinical research, and education.

The U’s Thrombosis Service team works closely with patients and staff throughout the hospital on prevention measures, blood-thinner medications, mechanical devices that promote blood flow, and education, which can reduce a patient’s risk of developing DVT or PE by 60 percent. They closely follow patients from the moment they are identified as at-risk for blood clots, prior to and during their hospital stay, after discharge, and during clinic visits.

“This wide spectrum of care allows us to follow patients through their entire anticoagulation therapy, reducing the risk of clots and bleeds,” says Laura Roller, pharmacy supervisor of the Thrombosis Service. “There’s opportunity to educate patients at every stage.”

Pendleton says that more than 90 percent of patients who are admitted and potentially at risk for DVT are receiving intervention to reduce that risk. Nationally, only 50 percent receive this kind of intervention.

This year, anti-coagulation (the prevention of blood clots) is a key initiative on the Joint Commissions 2008/2009 National Patient Safety report card for hospitals. “Our goal is now to make our approach ‘translatable’ for other hospitals to model,” says Pendleton. He and his staff organize DVT seminars (see below) and recently launched a Web site, http://healthcare.utah.edu/thrombosis, that includes the most recent research and education for patients and healthcare providers.

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