Independent Review of Pulmonary Embolism fatalities in England and Wales

Recent trends, excess deaths, their causes and risk management concerns

Tim Edwards ACII, CCRMP

October 2022

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Tim’s mother tragically passed away prematurely from PE in February 2022. Tim used his experience of working in the financial services industry risk of assessing and mitigating risk, to write a report putting in place meaningful action plans he hopes will be useful in reviewing the concern.

Prevention of HA-VTE in psychiatric inpatients

Prevention of HA-VTE in psychiatric inpatients.

A survey of current practice within Mental Health Trusts in England

Poster presented at the Royal College of Psychiatrists International Congress, Edinburgh 20-23 June 2022.

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Report: Clinical decision making: diagnosis and treatment of pulmonary embolism in emergency departmen

A national report by the Healthcare Safety Investigation Branch for Clinical decision making: diagnosis and treatment of pulmonary embolism in emergency departments

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Summary: Clinical decision making: diagnosis and treatment of pulmonary embolism in emergency departments

A national report by the Healthcare Safety Investigation Branch for Clinical decision making: diagnosis and treatment of pulmonary embolism in emergency departments

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2020: Research in VTE Management

An international survey of clinicians regarding their management

of venous thromboembolism following the initial 3–6 months

of anticoagulation

E. Banham Hall1 · A. Allison2 · A. Santarsieri3 · M. Gohel4 · M. P. Crowley5 · K. Sheares6,7 · W. Thomas3

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WHITE PAPER - SUMMARY

The impact of cancer-related comorbidities on patient treatment, treatment efficacy, survivorship, and quality of life

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WHITE PAPER

The impact of cancer-related comorbidities on patient treatment, treatment efficacy, survivorship, and quality of life

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Pulmonary embolism in hospitalised patients with COVID-19

Martin B. Whyte, Philip A. Kelly, Elisa Gonzalez, Roopen Arya, Lara N. Roberts, June 2020

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Hypercoagulability and Anticoagulation in Patients With COVID-19 Requiring Renal Replacement Therapy

Lara N. Roberts, Kate Bramham, Claire C. Sharpe and Roopen Arya, June 2020

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May 2020, Patient Experience of Living With Cancer Associated Thrombosis in France (Le PELICAN)

Isabell Mahe, Jean Chidiac, Mickael Pinson, Parinita Swarnkar, Anne Marie Nelson, Simon Noble

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May 2020, Research Trial Report: Graduated compression stockings as adjuvant to pharmaco-thromboprophylaxis in elective surgical patients (GAPS study): randomised controlled trial

Joseph Shalhoub, Rebecca Lawton, Jemma Hudson, Christopher Baker, Andrew Bradbury, Karen Dhillon, Tamara Everington, Manjit S Gohel, Zaed Hamady, Beverley J Hunt, Gerrard Stansby, David Warwick, John Norrie, Alun H Davies, on behalf of the GAPS trial investigators

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Patient experience of pregnancy-related venous thrombosis: A phenomenological study

Emma Geea, Lara Robertsa Roopen Aryaa Vicki Tsianakasb

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Making cancer-related complications and comorbidities an EU health priority

Thrombosis UK joined with organizations representing patients, nurses and health experts to call on the European Commission to take into account cancer-related complications as it designs its European Beating Cancer Plan.

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The NCEPOD Report

Highlighting the quality of care of patients aged 16yrs+ who had a PE, who either presented to hospital or who developed a PE whilst an inpatient for another condition.

526 cases of PE were reviewed.
Delays were recorded throughout the process of care with recognition, investigations and treatment the commonest reasons

 Principal recommendation 1:
Give an interim dose of anticoagulant to patients suspected of having an acute pulmonary embolism (unless contraindicated) when confirmation of the diagnosis is expected to be delayed by more than one hour. The anticoagulant selected, and its dose, should be personalised to the patient.
 Action: For query / suspected PE please flag to prescribers the need for therapeutic anticoagulation (unless contraindicated) if it is anticipated it will take or has already taken more than an hour to confirm diagnosis.

Full report, summary and implementation tools can be found at:

www.ncepod.org.uk/2019pe.html

Patient Experience of Living With Cancer‐Associated Thrombosis in Canada (PELICANADA)

Simon Noble MBBS, MD, FRCP Annmarie Nelson PhD Jill Scott RN Anne Berger RN Karen Schmidt RN Parinita Swarnkar Agnes Lee MD, MSc, FRCPC

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Impact of an All Wales Hospital Acquired Thrombosis Steering Group

Andrea Croft, Lead Advanced Nurse Practitioner - Anticoagulation, NHS Wales

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BMJ: An NHS success story that should be exported globally

Prof Beverley Hunt OBE

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Developing Optimal Standards of Care for the Prevention of Recurrent Venous Thromboembolism (VTE): Consensus Statement

Summary of consensus statements agreed at an Expert Working Group meeting to identify actions for improvements in the management of patients at risk of recurrent VTE.

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Optimal pathway for the prevention of recurrent VTE

Direct oral anticoagulants for the management of venous thromboembolism in patients with HIV – a single centre experience

Ricardo Oliveira, Raj K. Patel, Chris Taylor, Julia Czuprynska, Roopen Arya, Lara N. Roberts

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Oral anticoagulation is preferable to injected, but only if it is safe and effective: An interview study of patient and carer experience of oral and injected anticoagulant therapy for cancer-associated thrombosis in the select-d trial

Ann Hutchinson, Sophie Rees, Annie Young, Anthony Maraveyas, Kathryn Date and Miriam J Johnson

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A clinical prediction model for cancer-associated venous thromboembolism: a development and validation study in two independent prospective cohorts

Ingrid Pabinger, Nick van Es, Georg Heinze, Florian Posch, Julia Riedl, Eva-Maria Reitter, Marcello Di Nisio, Gabriela Cesarman-Maus, Noémie Kraaijpoel, Christoph Carl Zielinski, Harry Roger Büller, Cihan Ay
The Lancet July 2018

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Repeated assessments of physical activity and risk of incident venous thromboembolism

Evensen LH, Isaksen T, Hindberg K, Braekkan SK, Hansen JB

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Cost-Utility Analysis of Venous Thromboembolism Prophylaxis Strategies for People Undergoing Elective Total Hip and Total Knee Replacement Surgeries in the English National Health Service

Dalia M. Dawoud, David Wonderling, Jessica Glen, Sedina Lewis Xavier Griffin, Beverley J. Hunt, Gerard Stansby, Michael Reed, Nigel Rossiter, Jagjot Kaur Chahal, Carlos Sharpin and Peter Barry

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Cancer-associated thrombosis awareness survey - Results report - October 2018

European Cancer Patient Coalition
With support from LEO Pharma
Carried out by Quality Health Limited

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Quality of Care in the United Kingdom after Removal of Financial Incentives

Background:

The benefits of pay-for-performance schemes in improving the quality of care remain uncertain. There is little information on the effect of removing incentives from existing pay-for-performance schemes.

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Cancer patients’ experiences of living with venous thromboembolism: A systematic review and qualitative thematic synthesis - Hull York Medical School

Summary:

Cancer-associated thrombosis has an impact on patients’ lives. Many cancer patients do not know that they are at increased risk of getting thrombosis. Education for patients and clinicians should be part of routine care and further work is needed to make this patient priority equal to that of other cancer complications such as spinal cord compression or neutropenic sepsis.

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To register and read full paper, please visit: https://goo.gl/ikt4nY

To read more about the work group, please visit: https://hull-repository.worktr...

Dynamic Coagulability after Injury: Is Delaying Venous Thromboembolism Chemoprophylaxis Worth the Wait?

Background:

Severely injured patients often progress from early hypocoagulable to normal and eventually hypercoagulable states, developing increased risk for venous thromboembolism (VTE). Prophylactic anticoagulation can decrease this risk, but its initiation is frequently delayed for extended periods due to concerns for bleeding. To facilitate timely introduction of VTE chemoprophylaxis, we characterized the transition from hypo- to hypercoagulability and hypothesized that trauma-induced coagulopathy (TIC) resolves within 24 hours after injury.

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