From 1 April 2012 until 31 March 2022, NHS Resolutions documented 687 closed claims relating to Venous Thromboembolism (VTE) injuries. This digital resource details how clinicians take preventative action to improve outcomes for patients at risk of VTE.
Recent trends, excess deaths, their causes and risk management concerns
Tim Edwards ACII, CCRMP
October 2022
Tim’s mother tragically passed away prematurely from PE in February 2022. Tim used his experience of working in the financial services industry risk of assessing and mitigating risk, to write a report putting in place meaningful action plans he hopes will be useful in reviewing the concern.
Prevention of HA-VTE in psychiatric inpatients.
A survey of current practice within Mental Health Trusts in England
Poster presented at the Royal College of Psychiatrists International Congress, Edinburgh 20-23 June 2022.
A national report by the Healthcare Safety Investigation Branch for Clinical decision making: diagnosis and treatment of pulmonary embolism in emergency departments
A national report by the Healthcare Safety Investigation Branch for Clinical decision making: diagnosis and treatment of pulmonary embolism in emergency departments
An international survey of clinicians regarding their management
of venous thromboembolism following the initial 3–6 months
of anticoagulation
E. Banham Hall1 · A. Allison2 · A. Santarsieri3 · M. Gohel4 · M. P. Crowley5 · K. Sheares6,7 · W. Thomas3
The impact of cancer-related comorbidities on patient treatment, treatment efficacy, survivorship, and quality of life
The impact of cancer-related comorbidities on patient treatment, treatment efficacy, survivorship, and quality of life
Martin B. Whyte, Philip A. Kelly, Elisa Gonzalez, Roopen Arya, Lara N. Roberts, June 2020
Lara N. Roberts, Kate Bramham, Claire C. Sharpe and Roopen Arya, June 2020
Isabell Mahe, Jean Chidiac, Mickael Pinson, Parinita Swarnkar, Anne Marie Nelson, Simon Noble
Joseph Shalhoub, Rebecca Lawton, Jemma Hudson, Christopher Baker, Andrew Bradbury, Karen Dhillon, Tamara Everington, Manjit S Gohel, Zaed Hamady, Beverley J Hunt, Gerrard Stansby, David Warwick, John Norrie, Alun H Davies, on behalf of the GAPS trial investigators
Emma Geea, Lara Robertsa Roopen Aryaa Vicki Tsianakasb
Highlighting the quality of care of patients aged 16yrs+ who had a PE, who either presented to hospital or who developed a PE whilst an inpatient for another condition.
526 cases of PE were reviewed.
Delays were recorded throughout the process of care with recognition, investigations and treatment the commonest reasons
Principal recommendation 1:
Give an interim dose of anticoagulant to patients suspected of having an acute pulmonary embolism (unless contraindicated) when confirmation of the diagnosis is expected to be delayed by more than one hour. The anticoagulant selected, and its dose, should be personalised to the patient.
Action: For query / suspected PE please flag to prescribers the need for therapeutic anticoagulation (unless contraindicated) if it is anticipated it will take or has already taken more than an hour to confirm diagnosis.
Full report, summary and implementation tools can be found at:
Simon Noble MBBS, MD, FRCP Annmarie Nelson PhD Jill Scott RN Anne Berger RN Karen Schmidt RN Parinita Swarnkar Agnes Lee MD, MSc, FRCPC
Andrea Croft, Lead Advanced Nurse Practitioner - Anticoagulation, NHS Wales
Summary of consensus statements agreed at an Expert Working Group meeting to identify actions for improvements in the management of patients at risk of recurrent VTE.
Download Consensus Statement
Download Infographic:
Optimal pathway for the prevention of recurrent VTE
Ricardo Oliveira, Raj K. Patel, Chris Taylor, Julia Czuprynska, Roopen Arya, Lara N. Roberts
Ann Hutchinson, Sophie Rees, Annie Young, Anthony Maraveyas, Kathryn Date and Miriam J Johnson
Ingrid Pabinger, Nick van Es, Georg Heinze, Florian Posch, Julia Riedl, Eva-Maria Reitter, Marcello Di Nisio, Gabriela Cesarman-Maus, Noémie Kraaijpoel, Christoph Carl Zielinski, Harry Roger Büller, Cihan Ay
The Lancet July 2018
Evensen LH, Isaksen T, Hindberg K, Braekkan SK, Hansen JB
Dalia M. Dawoud, David Wonderling, Jessica Glen, Sedina Lewis Xavier Griffin, Beverley J. Hunt, Gerard Stansby, Michael Reed, Nigel Rossiter, Jagjot Kaur Chahal, Carlos Sharpin and Peter Barry
European Cancer Patient Coalition
With support from LEO Pharma
Carried out by Quality Health Limited
Background:
The benefits of pay-for-performance schemes in improving the quality of care remain uncertain. There is little information on the effect of removing incentives from existing pay-for-performance schemes.
Summary:
Cancer-associated thrombosis has an impact on patients’ lives. Many cancer patients do not know that they are at increased risk of getting thrombosis. Education for patients and clinicians should be part of routine care and further work is needed to make this patient priority equal to that of other cancer complications such as spinal cord compression or neutropenic sepsis.
To register and read full paper, please visit: https://goo.gl/ikt4nY
To read more about the work group, please visit: https://hull-repository.worktr...
Background:
Severely injured patients often progress from early hypocoagulable to normal and eventually hypercoagulable states, developing increased risk for venous thromboembolism (VTE). Prophylactic anticoagulation can decrease this risk, but its initiation is frequently delayed for extended periods due to concerns for bleeding. To facilitate timely introduction of VTE chemoprophylaxis, we characterized the transition from hypo- to hypercoagulability and hypothesized that trauma-induced coagulopathy (TIC) resolves within 24 hours after injury.
Prof Beverley Hunt, Professor of Thrombosis & Haemostasis, Kings College London, said:
“This study looked at 2 million women in Denmark and particularly studied those who were taking NSAIDs and contraception and their risk of having blood clots (deep vein thrombosis and pulmonary emboli). We knew already that the use of certain hormonal contraception increases the tiny risk of blood clots in healthy fertile women and that NSAIDs also increase the tiny risk of clots. What this study finds is that the risk of clots with NSAIDs is a little higher than shown in previous studies (still very tiny) but when combined with hormonal contraceptives which have the highest risk of clots, the risk was amplified. This is the first time the combination have been shown to have an enhanced risk. What is not known from the study is why the women were taking NSAIDs so it is not clear the NSAIDs causes the increased risk of clots directly or indicative that these women had an underlying problem causing pain which made them more immobile (a risk factor for clots). “
Dr Channa Jayasena, Clinical Senior Lecturer and Consultant in Reproductive Endocrinology and Andrology, Imperial College London, said:
“Blood clots are dangerous since they can lodge in the lungs causing breathing and heart problems. Contraceptive medications and painkillers like ibuprofen are essential for many women to avoid pregnancy and cope with period pain. We already know that both drugs can occasionally cause blood clots. This large study from Denmark shows that women taking ibuprofen-like drugs were more likely to have blood clots if they were also on the combined pill. Women on the coil or progesterone-only (mini) pill and women not on any contraceptive medications had lower risks of blood clots when taking ibuprofen-like drugs. It is a particular shame that the study did not test if obesity or smoking also increase blood clots risks when taking painkillers – I think they almost certainly would increase risks.
“Painkillers and the pill (like all drugs) can occasionally have cause serious side-effects. But I don’t think this study alone should put off women taking either the pill, painkillers, or both if needed. The most important message should be for all women to reduce blood clot risk by smoking cessation and weight loss.”