Having Surgery? Protect Yourself From Dangerous Blood Clots

Last updated: April 15, 2010
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If you or a family member is going to have surgery, you should know about an all-too-common danger and how to protect yourself. The danger is from blood clots that can form in other parts of the body, then move to the lungs, where they can cause death. I've been researching blood clots for Caring.com and need to issue this warning based on what I've found out. First, the scary facts.

Fact: "One of the most common causes of death among hospitalized patients is pulmonary embolism." (Source: Government report.) Pulmonary embolism is a fancy name for what happens when a blood clot moves from elsewhere in the body and lodges in the lungs.

Fact: Routine autopsies estimate that from 10 to 25 percent of all deaths in hospitals involve a pulmonary embolism from a blood clot. That's a lot - as high as one in four.

Fact: "Following general surgery, the approximate risk for deep venous thrombosis (DVT) is 15-40 percent." (Source: The National Institute of Health.) Deep vein thrombosis, or DVT, is a condition in which a blood clot forms in one of the deep veins in the body; the most common locations are in the legs and feet. The reason DVT is a big concern is that it often leads to pulmonary embolism, when the clot dislodges and moves up into the lungs, leading to death.

Fact: The risk of DVT nearly doubles after hip or knee replacement surgery or hip fracture surgery to between 40 and 60 percent. (Also from the NIH.)

Fact: Each year, between 50,000 and 200,000 patients will die from blood clots that obstruct blood flow to their lungs (pulmonary embolism).

What does this all mean? As many as 60 percent of patients who enter the hospital for hip or knee replacement surgery will end up with clots in the deep veins, clots which pose a serious risk of death or disability. As many as one in four people who have general surgery for other conditions will also get DVT.

What can you do to protect yourself and your family?

When planning any surgical procedure, talk to the doctor about the risk of blood clots and ask if you need pre- and post-surgical treatment to prevent blood clots. Oddly, there's a relatively simple set of preventative measures that hospitals can take, yet research shows that many hospitals still aren't routinely offering patients this protection.

Here's a quick summary of the risk factors that make it more likely you or your family member could develop a dangerous blood clot during or after surgery:

"¢ Age: Over 50
"¢ Have varicose veins
"¢ A smoker or former smoker
"¢ Taking estrogen
"¢ Have diabetes
"¢ History of stroke
"¢ History of heart attack
"¢ History of cancer

Here are the preventive measures hospitals can take:

1) They can have the patient wear graded compression elastic stockings.

2) They can use an external pneumatic compression device starting soon after the patient is admitted. This is usually an inflatable cuff or bootie that's inflated and deflated to apply intermittent pressure.

3) Nurses and physical therapists can begin movement and rehabilitation the first day after surgery; outpatient movement and physical therapy can also continue for several months.

4) They can administer an anti-clotting drug, also called anticoagulant therapy. You take Heparin or another clotting drug intravenously the night before surgery; you can continue taking the clotting drug after discharge until the doctor says you're out of risk.

A number of big studies have shown that when hospitals use these four steps prior to and after surgery, they cut the rate of DVT and embolism way down. The bottom line: Fewer patients die during or after surgery. Yet studies also show that many hospitals still aren't routinely offering these treatments.

When you sit down with your doctor to discuss any type of surgery, go over the risk factors that could put you or a family member at risk for blood clots and ask that preventive measures be used to protect against DVT and pulmonary embolism.

This is a definite case when "better safe than sorry" should be our motto.

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11 Comments So Far. Add Your Wisdom.

4 months ago

I had a bladder sling operation and use the estrogen cream before. Now I have a blood clot on my vagina. I still need to use the cream. Will this go away soon because it hurts to sit down.

5 months ago

I had spine surgery 6 days ago. I have the compression stockings but my big toe is really red and swollen and hurts to move it should I call A doctor?

8 months ago

I wish I had read this site before my husband went to hospital for a partial knee replacement as he died two days after surgery from a PE. He was given no compression stocking on his operative leg and no Heparin as he had slight bleeding and his doctor in his "wisdom" decided he shouldn't have the Heparin. He did have foot pumps the night of the surgery but they were not on when I visited him the next day. I assumed it was because they were busy bathing him etc. He was a very fit and healthy 59yr old and I am lost without him.

Anonymous said almost 2 years ago

This is really serious and people need to know to ask for prophylaxis. Compression stockings, meds, etc. A family friend just died in surgery due to PE. It should Not have happened. There are over 100,000 dealths every year due to blood clots related to surgery. Dangerous !!!1

over 2 years ago

my mother went in for a biopsy lung as she had a 2 cm spot at top of lung for several years whe decided against surgery due to her age 78 and monitored the spot over the next year or so it showed no significant growth or spreading but the surgeon wanted to operate as he said he could get it easily i agreed to a biopsy and after brother took her in to hospital i called to checkl on her and they had her in surgery for 3 hours and i raced down to hospital upset why the surgery finally doctor came into waiting room said no signs of cancer in lobes all negative and no spreading but he said the 2 cm mass was cancer it had not grown he said he cut top of lung 15% off and stapeled i was just so relieved she made it through surgery and no other signs of spreading ect she died 3 days later in the hospital of a clot that was caused by surgery i guess they were not monitoring her well enough and i am so upset i can die she was just playing with the dog before she went in she walked took her own bath and was very much loved i cant believe this happened what is your opinion on this i would be interested in how you would feel im a wreck this was not to happen apparently doctor was so sure it was going to be easy he took 5 hours to do this operation that my mom told me was to be only a biopsy and my brother was told same thing nopw shes dead i am so hurt please give some insight this was wrong

about 3 years ago

It provided information that may be of importance to me in a straight forward manner.

over 3 years ago

its true I had two of the above mentioned precautions after a hysterectomy but not the heparin. I had a pulmonary embolism at age 46 after surgery and luckily survived.

almost 4 years ago

I have blood clots in my thigh. I exercise daily. I must have a procedure for P.A.D Made three years ago, it stopped. I wanted to stop Coumadin. It appears on both legs. I was afraid that the clot formation again, but I was told that it is more a cosmetic procedure. I wear long shorts, because the bumps are so remarkable. My mother had these bumps too. She could not set store on them because of pain. I was always told they were fat cells and will appear if you are overweight. I' m not overweight at the moment. What are your suggestions. http://www.insideheart.com/causes-of-blood-clots.html

Anonymous said over 4 years ago

Rather good site to read it to my thinking. I have a question, why haven't you you add this post to social bookmarking sites? It should bring lots of traffic to this blog.

over 4 years ago

Thanks so much for sharing this story, avinger; this is exactly the type of self-advocacy that I'm talking about, that we're all being forced to do; good for you for finding out about the Lovenox and insisting!!! I'm so glad to hear you did that.

over 4 years ago

I have had 2 blood clots in my left leg. When I broke my right ankle and had to have surgery, I asked my doctor to give me Lovenox (clotting drug) injections after my surgery since I would have to be non weight bearing for 6 wks. When I got ready to go home and insisted on the Lovenox injections, the hospital had a problem getting the insurance company to approve the Lovenox injection for me to take at home (the hospitalist wanted to prescribe Coumadin but I was told it is not as fast acting as the Lovenox injection so I INSISTED on the Lovenox). I was so persistent that I had to stay over the weekend from Friday until Monday before they could get insurance company approval. If I had not asked & insisted, I would not have been put on any blood thinner after my surgery even with my history.

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