Venous thromboembolism: a chronic illness

Deep vein thrombosis (DVT) is a common disorder frequently seen in both the inpatient and outpatient settings. DVT increases the risk of pulmonary embolism, a potentially fatal complication. These 2 conditions--DVT and pulmonary embolism--comprise venous thromboembolism (VTE), which is a major and often unrecognized cause of morbidity and mortality in hospitalized and ambulatory patients. Acquired risk factors include smoking, obesity, stasis (such as long-term travel), hypercoagulability, recent surgery, trauma, or hospitalizations. In addition, inherited or innate disorders that pose risk include increasing age and personal or family history of VTE.After a first episode of VTE, the risk for recurrent episodes of a DVT is elevated: 21.5% after a first event and 27.9% after a second. And, the risk of recurrence varies with time, with highest risk occurring during the first 6 to 12 months after the event. Death occurs in 6% of DVT cases within 1 month of diagnosis. Once a DVT occurs, the risk recurrence never resolves to zero; therefore, VTE should be considered a chronic illness rather than a short-term condition. As a key member of the healthcare team, the role a nurse practitioner is to identify patients at risk for VTE and institute appropriate preventative/treatment measures. By doing so, morbidity and mortality from this common disorder can be minimized.