VTE

Recommendations for Reducing Death and Disability among Stroke Victims to be released at International Stroke Conference 2015

Guidelines Poised to Change Standard of Care for Stroke Treatment and Help Caregivers Lower Incidences of Venous Thromboembolism (VTE) in Ischemic and Hemorrhagic Stroke Patients

To reduce death and disability among stroke victims – and help healthcare providers lower rates of life-threatening venous thromboembolism (VTE) in ischemic and hemorrhagic stroke patients – leading neurological health and patient safety experts will release Stroke VTE Safety Recommendations during the International Stroke Conference (ISC) 2015, February 11-13 in Nashville.

Created by a group of leading neurological health and patient safety experts brought together by the Physician-Patient Alliance for Health & Safety, the Stroke VTE Safety Recommendations will be presented at a special luncheon taking place on the opening day of ISC 2015 – Wednesday, February 11 – from 12:50-1:30pm – CV Expert Theater, Booth 636.

Presenters will include:

  • Mark J. Alberts, MD (Clinical Vice-Chair for Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center)
  • Laurie Paletz, BSN, PHN, RN-BC (Stroke Program Coordinator, Cedars-Sinai Medical Center)
  • Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)

The recommendations take direct aim at reducing VTE, commonly referred to as blood clots, which is a common and preventable cause of death and illness in hospital patients. Each year in the United States, an estimated 300,000 cases of VTE occur.[i] Mortality can be as high as 3.8 percent in patients with deep vein thrombosis (DVT) and 38.9 percent in those with pulmonary embolism (PE). [ii] VTE is associated with a high risk of death in the United States and Europe, with an estimated incidence rate of 1 in 1,000 patients. [iii] VTE is particularly common after a stroke. Approximately 20 percent of hospitalized immobile stroke patient will develop DVT, and 10 percent a PE.[iv]

Culminating many months of lively dialogue and intensive research among the members of the Stroke VTE Safety Recommendations Working Group, the guidelines incorporate the landmark CLOTS 3 study – a groundbreaking study of nearly 3,000 stroke patients in the United Kingdom that compared the efficacy and safety of intermittent pneumatic compression (IPC) therapy against routine care (hydration, aspirin, graduated compression stockings and/or anticoagulants). Sponsored by the University of Edinburgh and the National Health Service, the randomized study found a 29-percent reduction in life-threatening deep vein thrombosis — and a 14 percent reduction in overall mortality — for patients receiving IPC therapy.[v]

CLOTS 3 was led by Martin Dennis, MD (University of Edinburgh, Western General Hospital), a member of the VTE Safety Recommendations Working Group, who predicts the study will transform the clinical practice to prevent DVT in stroke patients.

“CLOTS 3 showed for the first time that thigh-length IPC reduces the risk of DVT after stroke, and moreover improved survival,” Dr. Dennis said. “Therefore, I would expect its use to increase rapidly. Certainly in the UK, there are national programs to introduce IPC into all stroke units (and) national stroke audits are monitoring its use.”

The ISC 2015 luncheon is sponsored by the Covidien Group of Medtronic, the global leader in medical technology – alleviating pain, restoring health and extending life for millions of people around the world.

“The presentation of the Stroke VTE Safety Recommendations at the International Stroke Conference 2015 represents not only a landmark event in the advancement of patient safety, but also an incredible opportunity for clinicians throughout the world to significantly reduce the incidence of DVT in ischemic and hemorrhagic stroke patients,” said Michael Tarnoff, MD, vice president and chief medical officer, Covidien Group, Medtronic. “As a company, improving patient safety underscores everything we do and we are truly honored to be associated with this milestone occasion.”

[i] Furie, KL, MD, MPH, FAHA, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. 2011.

[ii] Bosson JL. Deep vein thrombosis in elderly patients hospitalized in subacute care facilities: a multicenter cross-sectional study of risk factors, prophylaxis, and prevalence. Arch Intern Med. 2003 Nov 24;163(21):2613-8.

[iii] Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing. NICE Guidelines. August 2014. http://www.nice.org.uk/guidance/CG144

[iv] Dennis MS, Sandercock P, Reid J, et al. Effectiveness of Intermittent Pneumatic Compression in Reduction of Risk of Deep Vein Thrombosis in Patients Who Have Had a Stroke (CLOTS 3): a Multicenter Randomized Controlled Trial. The Lancet. Published online May 31, 2013.

[v] Dennis MS, Sandercock P, Reid J, et al. Effectiveness of Intermittent Pneumatic Compression in Reduction of Risk of Deep Vein Thrombosis in Patients Who Have Had a Stroke (CLOTS 3): a Multicenter Randomized Controlled Trial. The Lancet. Published online May 31, 2013.

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