Posted: Fri May 18, 2007 8:36 pm Post subject: More deadly NHS negligence.
More deadly NHS negligence
Simple procedures that could save the lives of thousands of hospital patients every year are still not routine in Britain. More than 12,500 patients a year die in hospitals from venous thromboembolism (VTE), blood clots that form in the veins of the legs or pelvis and travel to the heart or lungs. David Fitzmaurice, of the University of Birmingham, says that the condition kills at least ten times as many hospital patients as MRSA but gets far less publicity. Nationally – counting cases both in and out of hospital – at least 25,000 people die in Britain every year from VTE. “The number of deaths from VTE in the UK each year is five times greater than the combined total number of deaths from breast cancer, Aids and road traffic accidents,” Professor Fitzmaurice says in today’s British Medical Journal.
In hospitals, about 10 per cent of all deaths are caused by VTE, and many of these could be prevented. Drugs can reduce the rate by about 65 per cent, but an investigation by the Commons Health Select Committee found that as few as 20 per cent of patients were being treated appropriately. “A combination of factors may be responsible,” Professor Fitzmaurice says. “As a result of poor education, health professionals lack awareness of this condition. Venous thromboembolism is often a silent disease and often occurs after discharge from hospital.” He adds that the cost of the drugs may also be a barrier, although this is not clear.
The National Institute for Health and Clinical Excellence (NICE) published guidance last month that all patients undergoing major surgery should be assessed to identify their risk of developing blood clots. The formation of clots, known as deep vein thrombosis (DVT), occurs in more than 20 per cent of surgical patients and more than 40 per cent of patients undergoing major orthopaedic surgery. But it is also common in medical patients. Most of these thromboses are minor and cause no symptoms, but if the blood clot becomes loose it can travel to the lungs and cause VTE.
NICE’s suggestions for preventing blood clots include offering patients compression stockings, inflatable “boots” during operations and the use of blood-thinning medication. Professor Fitzmaurice says that NICE’s emphasis on compression stockings rather than drugs is controversial. It was not supported by a report of the Health Select Committee two years ago, which he says provided an opportunity to change practice. “Meanwhile, more than 25,000 may have died needlessly each year because of the failure to implement simple thromboprophylaxis in UK hospitals,” he concludes.
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