Haemodialysis and Haemofiltration: Risk Factors

Risk Factors

Information on VTE1

  • VTE is a collective term for deep vein thrombosis (DVT) and pulmonary embolism (PE).
  • VTE is a significant cause of mortality, long-term disability and chronic ill-health problems, many of which are avoidable.
  • The incidence of VTE is 1–2 per 1,000 of the population and the risk increases with age.
  • Approximately half of VTE cases are associated with prior hospitalisation for medical illness or surgery.
  • It has been estimated that the management of hospital associated VTE costs the NHS £millions per year

VTE prevention is an important patient safety issue1

1 in 20 people will have a VTE at some time in their life and approximately half of the cases are associated with prior hospitalisation for medical illness or surgery

VTE causes a larger number of deaths than the combined mortality due to:2

  • Breast cancer
  • HIV
  • Road traffic accidents

VTE is the most common preventable cause of in-hospital death3

General risk factors4**

The general risk factors associated with the development of VTE (venous thromboembolism)

  • Active cancer or cancer treatment
  • Age >60 years
  • Critical care admission
  • Dehydration
  • Known thrombophilias
  • Obesity (body mass index [BMI] >30 kg/m2)
  • One or more significant medical comorbidities (e.g. heart disease; metabolic, endocrine or respiratory pathologies; acute infectious diseases; inflammatory conditions)
  • Personal history or first-degree relative with a history of VTE
  • Use of hormone replacement therapy (HRT)
  • Use of oestrogen-containing contraceptive therapy
  • Varicose veins with phlebitis

**For women who are pregnant or have given birth within the previous 6 weeks, please see section 1.16 of NICE NG89.

Reference

  1. NHS England. Commissioning Services that deliver High Quality VTE Prevention. Guidance for Commissioners. Available at: https://www.england.nhs.uk/wp-content/uploads/2013/08/vte-prev-guide-may2013-22.7.13.pdf
  2. Dolan G. J R Coll Physicians Edinb 2008;38:338–340.
  3. Cohen AT et al. Lancet 2008;371:387–394.
  4. NICE guideline 89. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. March 2018. Available at: https://www.nice.org.uk/guidance/ng89

*Including, but not limited to: congestive cardiac failure (NYHA class III or IV), acute respiratory failure or acute infection, who also have a predisposing risk factor for VTE such as age over 75 years, obesity, cancer or previous history of VTE.~
†In patients with chronic renal insufficiency or acute renal failure.

Fragmin® Guidelines

PP-FRA-GBR-0164.  June 2019