Leading Cause of Preventable Deaths in Hospitals
Venous thromboembolism (VTE) is the leading cause of preventable deaths in hospitals, accounting for an estimated 28,726 deaths annually in the United States among hospitalized patients, with three-quarters of the 500,000 VTE-related deaths in Europe attributed to hospital-acquired VTE. 1
Epidemiological Evidence
The magnitude of VTE as a preventable cause of hospital mortality is substantial:
Approximately 500,000 VTE events occur annually in the USA, with more than 600,000 deep vein thrombosis (DVT) events and 400,000 pulmonary embolism (PE) events across the European Union 1
52% of annually reported VTE in the USA were related to current or recent hospitalization, where 25% occurred during inpatient stay and 75% happened within 92 days of hospital discharge (median of 19.5 days) 1
VTE is recognized as a leading cause of morbidity and mortality in hospitalized patients, despite the existence of numerous evidence-based guidelines outlining appropriate prophylaxis 1
Context Among Other Hospital-Acquired Conditions
While other hospital-acquired infections are significant contributors to preventable mortality, the evidence hierarchy places VTE at the forefront:
Hospital-acquired infections (HAIs) affect 7-10% of hospitalized patients and account for approximately 80,000 deaths per year in the United States, making them the sixth leading cause of death 2, 3
Hospital-acquired pneumonia accounts for 40,000-70,000 deaths per year, representing the second most common hospital-acquired infection (17.8% of all HAIs) 4
Ventilator-associated pneumonia (VAP) and catheter-associated bloodstream infections are the leading causes of infection acquired in the ICU setting, but their overall mortality burden is lower than VTE across all hospitalized patients 4
The Prevention Gap
Despite the existence of evidence-based VTE prevention guidelines, there remains a significant gap between evidence and clinical practice:
Only 39.5% of medical patients at risk of VTE receive appropriate prophylaxis, compared to 58.5% of surgical patients, with compliance rates varying from 3% to 70% between countries 1
Multiple national initiatives have been implemented (US Surgeon General's call to action in 2008, Agency for Healthcare Research and Quality guidelines, UK National Institute for Clinical Excellence quality standards), yet there has been no decrease over time in VTE incidence or PE-related deaths in hospitalized patients 1
Clinical Implications
The preventability of VTE-related deaths makes this a critical patient safety priority:
VTE prevention has been designated as a top patient safety priority by the Agency for Healthcare Research and Quality 1
The high mortality burden combined with low prophylaxis compliance rates indicates substantial opportunity for mortality reduction through systematic implementation of existing evidence-based prevention strategies 1