Vascular surgeon Mounir ‘Joseph’ Haurani, MD, MPH of East Carolina University, recently spoke with Venous News, “the international newspaper for venous specialists,” about the current state of deep vein thrombosis (DVT) care, particularly the deficits in care for patients post-hospital discharge. Among his insights:
- More than 900,000 Americans are affected by venous thromboembolism (VTE) annually. Of those, 60,000 to 100,000 will die from complications of VTE, and a third of those deaths will be directly related to recent hospitalizations. “With this in mind, I would say we’re missing an opportunity to better predict who’s going to be at risk when they leave the hospital,” said Dr. Haurani.
- “It’s not just the short-term complications that we need to be concerned with and the mortality and morbidity associated with VTE, but the overall impact that it’s having on our healthcare expenditure system,” he said.
- “We have been taught to focus on the first two weeks after a traumatic injury, surgery or hospitalization as the riskiest timeframe for developing DVT because that’s when patients are at the highest risk for immobility, injury to their veins and stasis of blood flow. But what we often ignore is the fact that, longer term, those risks don’t go away once you leave the hospital. Patients don’t recover immediately after a two-week period. It takes, on average, several weeks to months for the normal homeostasis and physiological systems of the body to recover and get back to baseline.”
- He says compliance issues when the patient is back at home, such as an inability to afford or unwillingness to use medications, lack of transportation to follow-up appointments and other social risk factors too often escape the attention of clinical teams.
- Haurani lauds the “real shift” towards technology that enables more active management of DVT, including artificial intelligence and wearable devices.
- “I do think we need more guardrails that are not necessarily passive, but are there in the background … to heighten awareness in a way that isn’t intrusive,” he said.
- “So much of what we focus on is the episode of care in the hospital,” he said. “We have excellent acute-phase data. I think the deficit and what we need to do going forward is leverage the technology and the data that we have to improve long-term outpatient management. That’s where the research needs to go in the next decade.”
Read the full, very informative interview here.
