Call for all hospital patients to be checked for risk of fatal blood clots

ALL patients admitted to hospital in Scotland should be assessed for their risk of developing potentially fatal blood clots, new guidance says.

Experts believe that venous thromboembolism (VTE) - a range of conditions including deep vein thrombosis (DVT) and pulmonary embolism (PE) - is an escalating problem due to factors such as the ageing population.

But there are currently inconsistencies across Scotland in the diagnosis, prevention and management of the condition, meaning those at risk may not always be properly assessed.

The latest guidance, produced by the Scottish Intercollegiate Guidelines Network (SIGN), says treatment needs to be standardised, so all patients get the same level of care.

Experts said if the advice was followed, it would help save the lives of a significant number of patients. The guidance was welcomed by campaigners calling for greater recognition of the problems caused by blood clots.

Around one in 1,000 people per year will develop clinical symptoms of DVT. The deep veins of the lower limbs are affected most commonly, but thrombosis may affect other parts of the body.

In the worst cases, the disease can result in a pulmonary embolism - a blockage of the main artery of the lung, resulting in breathlessness, faintness, collapse, chest pain, coughing up blood or sudden death.

Patients going into hospital often have a higher risk of clots, due to their ill health and being immobile for long periods.

The new guidance from SIGN, part of NHS Quality Improvement Scotland, says that all patients going into hospital should be assessed for the risk of clots so they can be properly monitored.

Professor Mike Greaves, professor of haematology at the University of Aberdeen and chairman of the guideline group, said while this was happening in some places, it was not happening everywhere.

"It is a question of individual centres giving some attention to that and making sure that it is part of the routine, reminding people to do it," he said.

The guidance says that pregnant women should be assessed for risk factors linked to clots when receiving antenatal care.

The experts also said that the risks and benefits of blood thinning drugs given to try to reduce the risks of clotting should be fully discussed with patients.

While the preventative treatment can reduce the chance of someone developing a clot, it can also increase the risk of bleeding as it slows down the blood clotting process.

Gordon McPherson, a long-term campaigner for raising awareness of DVT after the death of his daughter Katie from the disease in 2003, welcomed the new advice.

"It is vital that NHS boards make diagnosis and treatment decisions based upon the best available evidence," he said.