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Airlines routinely warn about the risk of deep-vein thrombosis, the so-called economy-class syndrome, but a new study says doctors are not doing enough on the ground to prevent DVT cases.
In particular, people in the hospital, who may have risk factors such as obesity, surgery and prolonged immobility, do not always get simple, preventive care. And, the study found 71% of all sufferers had not received preventive care.
Treatments such as stockings to improve leg circulation and drugs have been shown to prevent blood clots and cut the DVT rate by two-thirds.
''This is a public health crisis,'' says Samuel Goldhaber, a DVT expert at Boston's Brigham and Women's Hospital, an author of the study in this week's American Journal of Cardiology.
Doctors today will try to rally support from other medical experts at a Washington meeting of the Coalition to Prevent Deep-Vein Thrombosis, a group, along with the American Medical Association, that hopes to raise awareness in medicine.
The condition begins when clots form in the large veins in the legs, especially after periods of immobility. It may cause leg cramps, but of the estimated 2 million people a year who have DVT, as many as half have no symptoms.
When a clot shears, fragments can land in the lungs and cause a pulmonary embolism (PE), leading to an estimated 200,000 U.S. deaths a year.
The public has learned more about DVT as the risks associated with airline travel have made news. But other factors such as hypertension or obesity don't always raise the DVT flag in the medical community.
For the study, paid for in part by Aventis Pharmaceuticals, Goldhaber and his team surveyed 5,451 people with DVT at 183 locations over six months. Two-thirds were overweight or obese, which increases the chances of developing PE. Other characteristics:
* 50% suffered hypertension.
* 38% had surgery within three months before the clot was found.
* 34% were immobile within 30 days of diagnosis of DVT.
* 32% had cancer.
Of the 2,726 patients who were hospitalized when diagnosed, only 42% had preventive care.
''This offers us opportunities to improve care,'' says the American Hospital Association's Nancy Foster. She says the best steps include ''getting patients up and moving.''
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