Venous thromboembolism has got much attention in western world as it is an important cause of death in hospitalized patients. VTE not only causes mortality, but also causes morbidity and increases hospital stay which produces burden on treatment cost and healthcare expenditure.

It comprises of deep vein thrombosis and pulmonary embolism. The risk lies in their presentation. Both can be asymptomatic and cannot be suspected at all. If undiagnosed, this will lead to chronic venous disease, repeated VTE and chronic thromboembolic pulmonary hypertension.1,2

Trend of VTE is increasing. Factors responsible are increasing age, surgery, prolonged stay in bed, malignancy, central venous catheter, trauma surgery. Increasing age is important as elder people have more co-morbidities like DM and HTN. Pregnancy, oral pills intake and hormone replacement therapy are added cause in women. Young patients are also found to have VTE as increasing DM and HTN in younger patients and lifestyle and sedentary works make them vulnerable to the situation.

With western data VTE is predominantly a disease of older age but in a study in India shows 44% patient are between 40-59 years, 34% below 40 yrs.3 We do not have any big study of VTE patients. Few small studies done in surgical patient.

Incidence of VTE is not known in our hospital admitted patient population. Many times, the cause of sudden death is unknown to us. It is believed that incidence of VTE is less in Asian people than Western people. But studies show the prevailing notion is wrong. Prophylaxis, early diagnosis, and intervention lower the mortality and morbidity in these patients.

It is essential to find incidence of VTE in hospitalized patients. Feasible methods for early detection are to be decided. Intervention and necessary prophylaxis will be planned to reduce the deleterious effect of VTE specially PE.

Lastly, VTE is a global disease. Its risk assessment if practiced and implemented for all hospitalized patients at admission and discharge, many deaths can be prevented.

 

References:

1.      Kahn SR, Ginsberg JS. The post-thrombotic syndrome: Current knowledge, controversies, and directions for future research. Blood Rev. 2002;16:15565.

2.      Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004;350:225764.

3.      Kamerkar DR, John MJ, Desai SC, Dsilva LC, Joglekar SJ. Arrive: A retrospective registry of Indian patients with venous thromboembolism. Indian J Crit Care Med. 2016 Mar; 20(3): 150158. doi: 10.4103/0972-5229.178178.