Background:
Deep vein thrombosis (DVT) and pulmonary embolism (PE) impose a major public health burden in the United States, affecting an estimated 350,000–600,000 individuals and accounting for approximately 100,000 deaths in the United States each year. Hospitalization is a major risk factor for DVT/PE, with a 10‐fold increased risk for venous thromboembolism (VTE) among hospitalized patients with acute medical illness and about 1 in 10 hospital deaths related to PE. The goals of this study were to measure DVT/PE awareness among patients hospitalized > 3 days and to identify barriers and gaps in evidence‐based prophylaxis practices as reported by these patients.
Methods:
A survey was conducted among 500 adults, screened from an online research panel, who had been admitted to a hospital for more than 3 days within 12 months of sampling.
Results:
Of the 500 patients surveyed, mean age was 52.5 yars (range, 20–801 years), and 64% were female. Length of hospital stay totaled 3–4 days for 51%, 5–10 days for 37%, and >10 days for 12%, with admissions for surgery, 43%; major illness, 32%; accident/trauma, 11%; childbirth, 6% other, 21%. Among all respondents surveyed, 72% (360) and 85% (425) had not heard of a condition called DVT or PE, respectively, when these specific terms were used, even though 15% reported a personal history of a blood clot in the leg or lung, and 43% said they had a family member who previously had a blood clot in the leg or lung. Among the 172 respondents who said they could name DVT risk factors, 45% cited sitting for a long time, and 9% cited surgery. Among the 109 respondents who could name DVT signs/ symptoms, 42% cited swelling in the legs, 38% pain in the legs, 23% skin redness/discoloration, and 22% skin being hot over the area. Of 103 respondents who said they could name PE signs/symptoms, 64% cited breathing difficulties, 36% chest pain/tightness, and 10% coughing up blood. Among all respondents surveyed, 83% said that they knew what a “blood clot” was, and 99% recognized that blood clots can be life threatening. About half of all respondents (46%) reported that their doctor or health care professional did not discuss the risk of DVT or blood clots related to hospitalization. Fewer than one third of all respondents report DVT prophylaxis with either an anticoagulant pill or anticoagulant injection. DVT prophylaxis reported by respondents included: 63%, ambulation; 39%, compression stockings; 37%, mechanical compression; 37%, aspirin; 29%, anticoagulant injection; 28%, anticoagulant pill.
Conclusions:
Despite a significantly increased risk of DVT/PE and a high reported personal and family history of blood clots, awareness of the specific terms DVT and PE and familiarity with DVT/PE risk factors is low, but awareness of the term blood clot is high. Interventions in the hospital setting are needed to improve patient understanding and awareness to optimize DVT prophylaxis and to reduce the related incidence of morbidity and mortality associated with DVT/PE among hospitalized patients.
Disclosures:
G. Maynard ‐ none; E. Varga ‐ none; J. Ansell ‐ Bayer, Ortho McNeil, Bristol Myers Squibb, Pfizer, Boehringer Ingelheim, Portola, Daiichi, ITC, Hemo‐Sense, Roche, Instrumentation Laboratories, consultant; Sanofi‐Aventis, speakers bureau; A. Brownstein ‐ Ortho‐McNeil, Bristol‐Myers Squibb, Eisai, GlaxoSmithKlline, Talacris Biotherapeutics, Lundbeck, Boehringer Ingelheim, HemoSense, QAS, Roche, Alexion Pharmaceuticals, Compression Management Services, ITC, Sanofi Aventis, research support; R. Friedman ‐ Johnson and Johnson, DJO Surgical, Pfizer, Boehringer Ingelheim, consultant; Astellas US, Boehringer Ingelheim, research support