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.