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BLOG: March 2020

DVT revisited

Pulmonary embolism (PE), and its usual cause, deep vain thrombosis (DVT, also Death may come from your legs), were causing significant morbidity and mortality in the U.S. more than a decade ago. Despite that, most people knew little, or nothing about them. Did things change for the better as we speak?

Somewhat surprisingly, the mortality rate plummeted in a couple of decades up to about 2010, dropping by some 50%, but after that is on the rise. No official explanation for these numbers seems to exist, so we can only guess about the real and statistical factors that had produced them.

Official estimate, according to the CDC (Center for Disease Control and Prevention) - which states that the exact numbers are unknown - is that every year some 900.000 Americans are affected with, as they call the condition, Venous Thromboembolism (VTE), and

about 100.000 of them die.

with the blacks having nearly twice higher mortality rates than whites [1].

That would put VTE among the deadliest health conditions. According to CDC, up to 30% will die within one month from diagnosis, and the first symptom in about one in every four that died from PE is sudden death.

VTE is also officially a leading cause of preventable hospital deaths in the U.S. But out of hospitals it kills even more: a recent study of nearly half a million surgeries at Department of Veterans Affairs (VA) hospitals found that about 6 in 10 patients that developed symptoms of VTE had them up to 90 days after discharge.

Estimates are that nearly 1/3 of patients discharged from hospitals in the United States, or

more than 12 million people [2],

are at risk of PE. And it is known to be a silent killer, because less than half of those who die were diagnosed with it prior to death [3].

Yet less than a half Americans know what is DVT, and only about a quarter say they know about VTE.

On top of that, the true incidence of any of these associated forms, DVT, PE and VTE, is unknown, simply because they are not monitored closely enough.

All this oblivion for dying from not being able to breathe because of PE is especially hard to understand in face of all the panic because of dying from not being able to breathe because of complications due to COVID-19.

The only difference is, really, that PE, in this year alone - the worst, and most likely the only significant COVID-19 year - will take up to 10 times more lives.

_____________

1. Fadhil et al. PULMONARY EMBOLISM MORTALITY IN THE UNITED STATES (1999-2015): ANALYSIS OF THE MULTIPLE CAUSE OF DEATH DATA, 2018

2. Anderson et al. Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism, 2007

3. Pineda et al. Clinical suspicion of fatal pulmonary embolism. Chest, 2001

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