Thromboembolism Risk Factors

Thromboembolism occurs when a blood clot becomes dislodged and is carried by the blood stream to block another vessel, such as one in the lung (pulmonary), brain, gastrointestinal tract, kidneys or legs. It is potentially fatal if not caught and treated quickly. Treatment and prevention of thromboembolism can consist of special drugs called anticoagulants, which thin the blood and prevent clots or drugs known as vasodilators that widen vessels.

Surgery

• Surgical patients are considered at high risk for developing thromboembolism. This is due to the immobility of patients during the procedure and post-op. Patients undergoing major orthopedic procedures, especially on lower extremities are at a particularly high risk for thromboembolism development. While patients are asked to stop any anticoagulant therapy pre-operatively (due to the risk of bleeding out during a procedure), they are typically re-started on anticoagulants 24 hours post-op, when they are primarily immobile and blood flow is compromised.

Trauma

• The ACCP (American College of Chest Physicians) states that risk for thromboembolism is exceptionally high in patients after a major trauma such as road traffic accidents. Thromboembolism is the cause of death is approximately one fifth of patients involved in road accidents. When patients are injured they sometimes go into a state of hypercoaguability due to the body's inflammatory response to injuries sustained which causes the blood to thicken and can lead to increased clotting.

Spinal Cord Injury

• Patients with acute spinal cord injuries are at the high risk for developing a thromboembolism. It is the third most common cause of death in these patients. Patients with these types of injury are considered high risk because of the inherent lack of mobility that comes with them. Movement is difficult and sometimes dangerous depending on the condition, leaving the patients blood flow to certain extremities compromised.

Acute Medical Illnesses

• Thromboembolism is also common in patients pneumonia, heart attacks, cancer and congestive heart failure. Again, these conditions put patients at risk because the patients are often immobile during recovery and treatment. Additionally, the patients inflammatory response to the illness may cause hypercoaguability.

History of VTE

• Patients with a prior history of thromboembolism will forever be considered a high risk for future clots. This is particularly true if the patient was found to have the Factor V Leiden gene mutation, giving them a lifetime risk for hypercoaguability.

Additional Risk Factors

• Pregnant women, women taking hormonal replacements and birth control pills are at a higher risk because of a blood clotting factor known as fibrinogen, which rises when estrogen levels are increased.