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November 01, 2007
DVT Thrombolysis
Sometimes it pays to be behind the cutting edge in medicine. The Dallas VA Chief of endovascular surgery, Dr. Timaran, revealed his findings of the analysis of a sample of patients treated at various hospitals in 35 states from 1998-2003 for DVT with thrombolytics (instead of the traditional anticoagulation). Only 2% of the 800,000 patients admitted with DVT in the US were treated with thrombolytics, in 2003. This was an increase on both counts from 1998, when 0.4% of the 485,000 were so treated.
Thrombolytics (read clot-buster) seem intuitively better than anticoagulants (read blood-thinner - which is not exactly how it works). So away doctors went, their patients expecting the best and the latest.
So in 1998, there were 1,940 so treated. By 2003, that was increased to 16,800. Maybe somewhere around 50,000 patients so treated. Over half of these had major bleeds and there was a 5-fold increase in intracranial bleeding. The risk of in-hospital death increased by 75%. Now we are only talking about a mortality of a little over 1%. So in 2003, there were 8,000 deaths amongst the DVT patients, but almost 300 of the 16,800. That might have escaped the notice of the doctors involved, though the huge, expected increase in bleeds should not have.
Isn't this a simple case of leap before you think?
| By Robert Maddox | 11:41 PM