Why is awareness of Thrombosis important?

A man admitted into hospital following a road traffic accident appeared to be making an excellent recovery. He was well-known locally and was chatting heartily with visitors one afternoon but by dusk he had died suddenly. I observed this as a medical student (decades ago) and was shocked. I have since encountered similar cases involving relatives and colleagues of mine.

A doctor recovering from an operation that went well died unexpectedly while in hospital. Another doctor died suddenly while recovering at home with one leg in an orthopaedic plaster. The clinical explanation for these deaths is venous thromboembolism (VTE). This is a condition in which a blood clot (thrombosis) forms in a vein. A chunk of this clot may break off and be carried in the blood stream to the lungs (this is called ‘pulmonary embolism’, PE). Immobilisation due to surgery or other medical conditions predisposes to clot formation. Obesity and genetic factors increase the risk but VTE could happen to anybody. If the dislodged clot is large enough it will cause instant death. If it isn’t, there may be time to treat PE. If untreated, death will occur in 1 in 3 cases; the death rate in treated cases is 1 in 50.

The best treatment is prevention; this includes ambulation, hydration, use of compression stockings and blood-thinning injections. In the UK, VTE was the biggest killer of pregnant women until prevention guidelines were implemented. Deaths from hospital-associated VTE in the UK have also been reduced substantially, with hospitals being required to assess VTE risk in at least 90% of their patients, but some cases are still missed.

The first step

The first step towards reducing the number of deaths from thromboembolism is AWARENESS. Unfortunately awareness of VTE in Nigeria (as in many countries across the world) is low, among health professionals and the public at large. Studies show that there is a deficiency in the knowledge and practice of VTE prevention among surgeons in Nigerian teaching hospitals: while 90% of surgeons have encountered VTE in their practice only 1 in 5 appear to have good practice in VTE prevention.

Let’s start today

Let us start today to raise awareness of VTE among Nigerian doctors and the public. If you are a Nigerian reading this post please share it with your friends (health professionals and the public) and encourage them to spread it in their own networks. Together we can generate swirls of AWARENESS and, who knows, a life saved could be that of your parent, spouse, sibling, friend – or your own.

Click the button below to download an Abstract of oral presentation at the annual conference of the Society of Obstetricians and Gynaecologists of Nigeria (SOGON), Sokoto, 23-25 November 2017.

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