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Venous thromboembolism caused 25 000 deaths a year, say MPs

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7491.559-c (Published 10 March 2005) Cite this as: BMJ 2005;330:559

Rapid Response:

DOH response to House of Commons Select Committee advice on VTE prophylaxis: numerous preventable cases of fatal and non-fatal pulmonary emboli amongst patients admitted to hospital with emergency medical presentations seem inevitable.

Sir,

We read with great concern the statement issued by the Department of Health regarding the recent Health Select Committee recommendation that NICE guidance on VTE prophylaxis should be expedited (1). It is a inconceivable in the light of the Select Committee recommendations(2) that the terms of reference of the NICE guidance will not be expanded to include advice on VTE prophylaxis in non-surgical patients, and in particular those with emergency medical presentations.

In the International Journal of Clinical Practice this week, data showing that a VTE risk assessment form is 100% effective when used to assess thromboprophylaxis requirement in emergency medical admissions are published(3). The paper presents further data showing that implementation of a VTE prophylaxis policy can lead to progressive and dramatic improvement in appropriate thromboprophylaxis use with nearly all at risk patients receiving therapy.

Given these data and the high number of emergency medical admissions (many of whom are at significant risk of developing venous thrombosis whilst in hospital) in the UK annually, we find it extraordinary that the Department of Health has opted to procrastinate and ask NICE to issue guidance relating solely to some groups of surgical patients. It was also disappointing to note that the Department of Health’s statement suggests that there has been a fundamental failure to distinguish between treatment and prevention of VTE. Surely prevention is far superior to treatment?

We would call on the Department of Health to consider published evidence, and review its position both with respect to the timing and also scope of the NICE guidance.

References

1. Coombes R. Venous thromboembolism caused 25 000 deaths a year, say MPs. BMJ 2005: 330; 559

2 House of Commons Health Committee. The Prevention of Venous Thromboembolism in Hospitalised Patients. Second Report of Session 2004- 05. 2005: The Stationary Office Limited

3 Sooriakumaran P., Burton L., Choudary R. et al. Are we good at thromboembolic disease prophylaxis? – an audit of the use of risk assessment forms in emergency medical admissions. Int J Clin Pract, 2005: (In Press, doi : 10.1111/j.1742-1241.2005.00525. x)

Competing interests: None declared

Competing interests: No competing interests

22 March 2005
George A Thomson
Consultant Physician
Devaka J.S. Fernando, Prassana Sooriakumaran, Roger H Lloyd-Mostyn
Kingsmill Hospital, Sherwood Forest Hospitals NHS Trust, Sutton in Ashfield, NG17 4JL