Venous thromboembolism (VTE)
All chronic disease leads to an increased risk of venous thromboembolism and is a common cause of hospital admission. D dimer measurements in this population are generally unhelpful and therefore radiological imaging in those with advanced disease processes is often required.
Risk factors
Section titled “Risk factors”- Cancer of any site, but especially those with pelvic involvement
- Recent chemotherapy
- Recent surgical procedures
- Immobility
- Cardiac, respiratory, or renal disease
- Thrombophilia
- Older age (>65 years)
- Hormonal medications
- Indwelling medical devices such as lines
Treatment
Section titled “Treatment”- While investigating for VTE, treat with low molecular weight heparin (LMWH)
- Once confirmed, the patient will either continue LMWH or commence oral anticoagulation direct oral anticoagulant (DOAC), or in certain cases, warfarin
- Choice of long-term anticoagulation will depend on prognosis, liver function, renal function and bleeding risk in each individual patient
- Patient risks and benefits must be regularly reassessed as there may come a point where burden of treatment is no longer beneficial