Surgeon General: Doctors and patients must be more aware of deadly clotting problems

The Associated Press and Lauran Neergaard reported a new effort by the acting Surgeon General to bring attention to the danger associated with blood clotting and the accompanying deaths.  Described as a "silent killer" that is difficult to diagnose, the Surgeon General noted that deep vein thrombosis, or DVT, refers to clots that form in large veins, usually in the leg or groin, and which can result in immediate death if they move into the lungs in the form of a pulmonary emboli (PE). 

While pulmonary emboli have been discussed recently in the context of long airplane flights, the more common risk factors and triggers are recent surgery or a fracture, pregnancy and birth control medication, or other periods of sustained immobility.  The risk rises with age, particularly after 65.  Symptoms may include pain, particularly in a calf; areas of swelling, warmness, or discoloration on the leg; sudden unexplained shortness of breath or pain on deep inspiration.

The studies suggest that doctors are also poorly informed on this problem.  They suggest that one-third of patients who should be prescribed protective blood thinners after major surgery do not get them.  As a preventative incentive, starting October 1, Medicare will begin withholding payment from hospitals when patients develop clots after knee- or hip-replacement surgery.