Individual research recommendation details

Recommendation ID

NG89/1

Question

Risk assessment:- What is the accuracy of individual risk assessment tools in predicting the risk of venous
thromboembolism (VTE) and risk of bleeding in people admitted to hospital?

Any explanatory notes
(if applicable)

Why this is important:- Risk assessment is a mandatory for all people admitted or having day procedures in hospital. Since 2010, the National VTE Risk Assessment Tool has been widely used in the NHS to assess a person's risk of VTE. This tool has not been validated or tested against other tools to evaluate its diagnostic accuracy or effectiveness at correctly identifying people at risk of VTE. There is concern that the tool may not accurately identify those who are most likely to get VTE.
According to national figures, over 70% of medical patients in the UK have prophylaxis when the national tool has been used, with some trusts offering prophylaxis to over 90% of medical patients.
Around 40% of medical patients have prophylaxis in largely US-based populations when other tools
are used (although this may partially relate to different indications for hospital admission). It is not
known if this means that the national tool identifies too many people or the other tools do not identify enough. The potential impact of giving unnecessary prophylaxis is that people may be at increased risk of bleeding and discomfort through repeated injections. There is also the potential for reducing the cost of thromboprophylaxis by better defining 'at risk' populations, so that the number of those given thromboprophylaxis is reduced.

Source guidance details

Comes from guidance

Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism

Number

NG89

Date issued

March 2018

Other details