Letters: Pulmonary embolism in hospital is overlooked

I was encouraged to see a section on 'vascular complications' in Mr Lee Jeys' article on hip and knee replacements (GP, 25 September).

The risk of DVT and fatal pulmonary embolism (PE) associated with orthopaedic surgery is vastly underestimated in the UK compared with the US.

It is not just orthopaedic surgery patients who are at risk. Indeed, any surgical or medical inpatient is at risk; particularly trauma, bariatric, obstetric, gynaecological and cancer patients. Obesity, pregnancy and immobility are also risk factors.

Yet, despite the fact that the risk of dying from PE due to hospitalisation is at least 1,000 times greater than dying from PE as a consequence of air travel, the appropriate preventive measures are at times overlooked.

The DoH has recently introduced measures to ensure that all patients are assessed for risk of VTE on admission.

This is an important first step in reducing the number of deaths caused by PE, but the next step is to ensure that surgeons are fully aware of the options available to them to mitigate that risk.

Public awareness campaigns around the risk of DVT from air travel have been highly effective (if not over-sensationalised). Similar campaigns about PE prevention could save 25,000 lives every year in the UK alone.

Dr Steven Moser, consultant interventional radiologist, Hammersmith Hospital, London

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