press release: Survey Reveals a Majority of Cancer Patients, Survivors Are Unaware of Higher Risk for Developing Deep-Vein Thrombosis and Pulmonary Embolism

Survey Reveals a Majority of Cancer Patients, Survivors Are Unaware of Higher Risk for Developing Deep-Vein Thrombosis and Pulmonary Embolism

NEW YORK, March 7, 2012 /PRNewswire/ — Focusing attention on patient groups at high risk for deep-vein thrombosis (DVT), the Coalition to Prevent DVT has found that a majority of people with cancer were not aware of an increased risk for DVT and its potentially fatal complication, pulmonary embolism (PE). Additionally, few had discussed their risk with their healthcare provider, according to a survey released by the Coalition as part of the ninth annual DVT Awareness Month.
Up to 2 million Americans are affected by DVT annually, and complications from DVT/PE kill up to 300,000 people in the U.S. each year – more than AIDS and breast cancer combined.^1,2 Up to 20 percent of all cases of DVT and PE occur in cancer patients,³ and DVT/PE are the second leading cause of death among cancer patients.⁴
“Almost anyone fighting cancer is at heightened risk for developing a DVT,” said Coalition steering committee member Craig Kessler, M.D., professor of medicine and pathology, Georgetown University Medical Center.........

EvidenceUpdates: Comparing the diagnostic performance of 2 clinical decision rules to rule out deep vein thrombosis in primary care patients including commentaries

Note: secondary link below w/o commentaries BUT full free access, also see Table 1 for risk factors including malignancies:

Comparing the Diagnostic Performance of 2 Clinical Decision Rules to Rule Out Deep Vein Thrombosis in Primary Care Patients

(why it's important)

"With an annual incidence of 1 to 2 per 1,000 inhabitants, deep vein thrombosis (DVT) is relatively rare in primary care, but it is feared for its associated morbidity and mortality if left untreated...."

National Guideline Clearinghouse | Outpatient management of uncomplicated deep venous thrombosis.

Cochrane Collaboration review: Elastic compression stockings for prevention of deep vein thrombosis

Background

One of the settings where deep vein thrombosis (DVT) in the lower limb and pelvic veins occurs is in hospital with prolonged immobilisation of patients for various surgical and medical illnesses. Using graduated compression stockings (GCS) in these patients has been proposed to decrease the risk of DVT.

Objectives

To determine the magnitude of effectiveness of GCS in preventing DVT in various groups of hospitalised patients.

Authors' conclusions

GCS are effective in diminishing the risk of DVT in hospitalised patients. Data examination also suggests that GCS on a background of another method of prophylaxis is more effective than GCS on its own.

Plain language summary

Elastic compression stockings for prevention of deep vein thrombosis during a hospital stay
Hospital patients can develop deep vein thrombosis (DVT) in the legs and pelvic veins immediately after surgery or if they are not mobile because of a medical illness. Symptoms vary from none to pain and swelling in the legs. A blood clot can move from the leg to the lungs with the danger of pulmonary embolism and death. Usually the DVT clears up or has long term effects such as high venous pressure in the leg, leg pain, swelling, darkening of the skin or inflammation.

DVT can be prevented using compression or drugs but drugs may cause bleeding, which is a particular concern in surgical patients. Graduated elastic compression stockings help prevent blood clots forming in the legs by applying varying amounts of pressure to different parts of the leg. Our review confirmed that graduated compression stockings reduce the risk of DVT in hospitalised patients. Our findings also suggest that wearing elastic stockings as well as receiving another method of prophylaxis has increased benefit. We identified 18 randomised controlled trials, eight comparing wearing stockings to no stockings and 10 comparing stockings plus another method with that method alone in patients undergoing surgery. The other methods used were Dextran 70, aspirin, heparin and mechanical sequential compression.

Evidence-Based Medicine Requires Appropriate Clinical Context - re: Deep VeingThrombosis (excerpt)

"What if a patient—after diagnostic tests have been performed and there is no more certainty to obtain—still has a 1 in 100 chance of having venous thromboembolism (VTE)? Should the patient's physician engage the patient in a discussion of the harm and benefit of anticoagulation? What if the chance of VTE was 1 in 20? Or even 1 in 10?"