Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Awareness and Prophylaxis Practices Reported by Patients with Cancer

Aggarwal, Anita; Fullam, Lisa L; Brownstein, Alan P.; Maynard, Gregory; Ansell, Jack; Varga, Elizabeth; Friedman, Richard J.; Rickles, Frederick R.

doi:10.3109/07357907.2015.1048871

Cited by 28 publications

(29 citation statements)

References 33 publications

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“…Similarly, they were unaware of important risk factors such as cancer, which corroborates the findings of other studies in which awareness of cancer as a risk factor for VTE was poor among oncology patients [21, 22]. This information is crucial, because it helps patients to understand the rationale for thromboprophylaxis during cancer treatment; thus, cancer patients should receive more information.…”

Section: Discussionsupporting

confidence: 82%

Awareness of venous thromboembolism and thromboprophylaxis among hospitalized patients: a cross-sectional study

et al. 2017

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BackgroundPatient awareness of venous thromboembolism (VTE) and thromboprophylaxis is essential for their safety. In this study, we evaluated patients’ awareness of VTE and their perceptions of thromboprophylaxis.MethodsWe administered a cross-sectional survey to patients hospitalized at the King Abdulaziz Medical City, Riyadh, Saudi Arabia.ResultsOf 190 patients approached, 174 completed the survey, constituting a response rate of 95%. Most participants (72%) were receiving thromboprophylaxis. However, only 32 and 15% reported knowledge of deep vein thrombosis (DVT) and pulmonary embolism (PE), respectively. Fifty-five percent of participants with knowledge of DVT identified swelling of the leg as a symptom. Risk factors for blood clot development were correctly identified by about half of participants, although most agreed that blood clots can cause death (77%). The level of awareness of DVT or PE did not significantly differ by respondents’ demographics. However, awareness of DVT or PE was significantly higher among those with a personal or family history of VTE. Participants had positive perceptions of thromboprophylaxis and were satisfied with treatment (> 69%), but perceived its adverse effects less favorably and reported lower satisfaction with the information provided about DVT and PE (46%).ConclusionThis study demonstrates the lack of awareness of VTE, DVT, and PE among hospitalized patients. More attention must be paid to patient education to ensure safe and high-quality patient care.

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Section: Discussionsupporting

confidence: 82%

Awareness of venous thromboembolism and thromboprophylaxis among hospitalized patients: a cross-sectional study

et al. 2017

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“…Their findings are remarkably consistent with the results of our global awareness survey [2]. Together, the results indicate we have much more work to do to improve the public awareness of thrombosis and VTE in particular.…”

Section: Disclosure Of Conflict Of Interestssupporting

confidence: 86%

“…The level of awareness was lower than that for other serious diseases such as heart attack and stroke (88% and 85%, respectively). In particular, we were not surprised by their findings that only 45% (95% confidence interval [CI], 43.9-46.5) of respondents were aware that blood clots were preventable, and even fewer of these non-selected respondents reported awareness that cancer, hospitalization and surgery are risk factors for VTE (16%, 25% and 36%, respectively).The findings of Wendelboe et al[1] are consistent with the results of our recently published survey of cancer patients, in which we demonstrated a similar low rate of awareness of VTE terminology amongst this high-risk patient population [2]. In brief, we conducted an online survey to measure awareness of PE and DVT terminology and understanding of the risks of VTE among a panel of 500 patients (294 treated as outpatients only and 206 who had been admitted to hospital during their treatment).…”

supporting

confidence: 89%

Global public awareness of venous thromboembolism: comment

Aggarwal

Rickles

2016

Journal of Thrombosis and Haemostasis

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We read with interest the article by Wendelboe et al. [1], in which the authors reported a low public awareness of venous thromboembolism (VTE). In their large survey of > 7000 respondents from the general population of nine countries, 68%, 44% and 54% of the respondents were aware of the terms 'thrombosis, deep vein thrombosis (DVT) and pulmonary embolism (PE)', respectively. The level of awareness was lower than that for other serious diseases such as heart attack and stroke (88% and 85%, respectively). In particular, we were not surprised by their findings that only 45% (95% confidence interval [CI], 43.9-46.5) of respondents were aware that blood clots were preventable, and even fewer of these non-selected respondents reported awareness that cancer, hospitalization and surgery are risk factors for VTE (16%, 25% and 36%, respectively).The findings of Wendelboe et al.[1] are consistent with the results of our recently published survey of cancer patients, in which we demonstrated a similar low rate of awareness of VTE terminology amongst this high-risk patient population [2]. In brief, we conducted an online survey to measure awareness of PE and DVT terminology and understanding of the risks of VTE among a panel of 500 patients (294 treated as outpatients only and 206 who had been admitted to hospital during their treatment). The diagnosis of cancer had been established in all of the respondents within the preceding 12 months. Of these 500 patients, 24% and 15% had heard of the terms DVT or PE (Table 1); 19% and 17% could name signs and symptoms of DVT and PE; 33% reported cancer as a risk factor for 'blood clots'; 3% stated that cancer treatments were risk factors for DVT and PE. Only 25% of the patients received education regarding prevention from providers; < 50% received VTE prophylaxis. Cancer outpatients were significantly less aware of the terms DVT and PE than their inpatient counterparts (Table 1). Nearly equal numbers of inpatients (76%) and outpatients (79%) were aware of the term 'blood clot'. When asked if they could identify or name risk factors for DVT, 155 of 500 (31%) responded positively. Of these, 45% identified sitting for too long, 9% identified travel, 8% identified being overweight, 7% identified being bedridden, 8% identified surgery and only 4% identified chemotherapy, radiation or some form of cancer treatment as risk factors. Significantly more inpatient respondents were aware of risk factors for DVT (P < 0.05) (

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“…[13–15] An epidemiology study based on the National Blood Clot Alliance revealed that poor awareness of VTE has been raised among cancer patients, and more effective communication between patients and physicians about thromboprophylaxis is of great importance. [16] On the other hand, VTE can be the earliest sign of tumor development, but early screening of occult tumors in VTE patients is disputable. A randomized controlled clinical trial assessing the screening strategy by abdomen-pelvis computed tomography suggested poor relevance between 1st episode of unprovoked VTE and occult tumor.…”

Section: Discussionmentioning

confidence: 99%

Silent pulmonary thromboembolism in neurosurgery patients

et al. 2016

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Background:The requirement of postoperative bedridden and immobilization renders neurosurgical patients with higher risk of deep vein thrombosis (DVT), then more vulnerable for pulmonary thromboembolism (PTE). But silent pulmonary thromboembolism (SPTE) can be the very early stage of any typical form of PTE, its diagnosis and management is therefore critical in neurosurgical departments. However, to date, perioperative SPTE has not been attached with enough attention.Methods:Here, we report 2 cases of perioperative SPTE in the Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China. Clinical data of 2 cases was collected and analyzed. Both patients were screened by quantitative D-dimer assay and lower limbs ultrasonography, while diagnoses were made according to computed tomographic pulmonary angiography (CTPA). Therapeutic medications include heparin, low molecular weight heparin, followed by long-term anticoagulation with oral warfarin. Both cases showed significantly elevated D-dimer before and after onset of SPTE. But in 1 case, ultrasonography reported negative venous thromboembolism. CTPA confirmed all diagnosis of SPTE. Repeated CTPA after anticoagulant therapy identified therapeutic efficacy. And during the follow-up period of 5 or 6 years, both patients acquired full recovery without clinical complications.Results:Significant decline of D-dimer was observed after the comprehensive management of SPTE (case 1: preop vs postop 573 vs 50 μg/L; case 2: preop vs postop 246 vs 50 μg/L). Ultrasonography was used for suspicious of DVT, while CTPA was used for confirming SPTE diagnosis.Conclusion:Clinicians should be aware of the importance of early recognition of SPTE. Effective management of risk factors of hyper-coagulation state should be the key to prophylaxis. And routine monitor of D-dimer as well as regular check of lower limbs ultrasonography should be standardized and included in guidelines of neurosurgical patient management.

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Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Awareness and Prophylaxis Practices Reported by Patients with Cancer

Cited by 28 publications

References 33 publications

Awareness of venous thromboembolism and thromboprophylaxis among hospitalized patients: a cross-sectional study

Awareness of venous thromboembolism and thromboprophylaxis among hospitalized patients: a cross-sectional study

Global public awareness of venous thromboembolism: comment

Silent pulmonary thromboembolism in neurosurgery patients

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