Article summary
- Venous thromboembolism (VTE) remains a leading cause of preventable hospital deaths and readmissions nationwide.
- About 60% of post-surgical VTE cases occur after discharge – nearly half within the first week – with risk persisting for weeks to months.
- Up to 70% may be preventable through measures such as blood-thinning medications and compression stockings. Clinicians are encouraged to reassess VTE risk at discharge, educate patients on warning signs and consider extended prophylaxis for high-risk patients.
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March is recognized as Blood Clot Awareness Month. Ballad Health’s Anticoagulation Stewardship Committee aims to highlight a crucial patient safety issue impacting many surgical patients: blood clots that form after leaving the hospital.
Why this matters
Research indicates that most post-surgical blood clots, known as venous thromboembolism or VTE, don’t occur during hospitalization. Studies consistently show around 60% of these clots happen after patients return home, with approximately 40% occurring within 30 days of discharge.
The timing of risk may be unexpected; nearly half of these clots develop within the first week post-surgery, yet many emerge in the third or fourth week. Patients also remain at increased risk two to three months after discharge.
The positive news? Up to 70% of these blood clots could be prevented through measures like blood-thinning medications or compression stockings.
What steps can clinicians take?
Here are three evidence-based strategies to safeguard patients:
- Reevaluate VTE risk at discharge: Take a moment to assess each patient’s clot risk before they leave, particularly those with high-risk factors such as cancer, extended hospital stays or major surgery.
- Educate patients on warning signs: Make sure patients know their risk persists after leaving. Teach them to identify symptoms like leg swelling, pain, shortness of breath or chest pain, and advise when to seek urgent care.
- Consider extended prophylaxis: For high-risk surgical patients, longer durations of blood clot prevention (ranging from 10 to 30 days) have shown significant benefits in reducing post-discharge events.
The importance
VTE remains a leading cause of preventable hospital deaths in the U.S. and the fifth-most common reason for unplanned hospital readmissions following surgery. Addressing the weeks and months after discharge is vital to preventing severe complications and enhancing patient outcomes.
Resources for clinicians and patients
- CDC Stop the Clot, Spread the Word ®: Patient education tools and kits at www.cdc.gov/blood-clots/stoptheclotspreadtheword/index.html
- CDC E-Learning Course for Healthcare Professionals: Free, self-paced training on VTE detection and management at www.cdc.gov/blood-clots/hcp/training/index.html
- National Blood Clot Alliance: Extensive resources for patients and providers at www.stoptheclot.org/
- Anticoagulation Forum (AC Forum): Clinical guidelines, webinars, and stewardship resources at https://acforum.org/
For questions about VTE prevention strategies or individual risk assessments, please contact Molly Lassiter, PharmD, Co-Chair, at molly.lassiter@balladhealth.org; or Herbert Ladley, MD, Co-Chair; or Stacey Lewis, RN, Nursing Stewardship Champion.
