Venous thromboembolism (VTE) is a medical condition in which a blood clot forms in a deep vein of the body.
VTE is the broad term which encompasses clots which form in a deep vein of the body and they may go by several names, depending on the location of the clot: deep vein thrombosis (DVT), pulmonary embolism (PE), sinus vein thrombosis (SVT), cerebral vein thrombosis(CVT), portal vein thrombosis (PVT), mesenteric vein thrombosis (MVT).
Public health scope of VTE
“Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) represent a major public health problem, exacting a significant human and economic toll on the Nation.”-US Surgeon General 2008 Call to Action
VTE is a leading cause of death and disability:
- Over 900,000 Americans have a VTE event each year and it causes more deaths than breast cancer, AIDS and car crashes combined.,
- VTE is the third leading cause of death, but is not widely known because VTE is excluded from CDC Vital Statistic reports which reflect only 113 select causes of death.
- Upwards of a third of VTE patients die within one month of diagnosis.
- Even with optimal medical care, half of VTE patients will have long-term complications and one-third will have a recurrent clot within 10 years.
- VTE is the leading cause of preventable hospital deaths in the United States. ~60% of VTE are associated with hospitalization.
- VTE is the leading cause of maternal death in the United States.
- An estimated $7-12 billion in medical costs in the US each year can be attributed to DVT and PE.
- High levels of anxiety, depression and psychological stress have been reported among patients with VTE.
By comparison to other better known conditions:
- AIDS funding = $31.7 billion, CDC portion of AIDS funding = $927.8 million10
- Breast & cervical cancer funding (in 1 combined line-item), CDC = $169 million
- FY17budget proposal, current funding, past CDC efforts
- Background on why VTE is excluded from CDC Vital Statistic reports
- Needed federal action to target VTE (see near end of article)
My Suggestions on Federal Action Needed to Change These Statistics
To target VTE, the President and Congress need to:
- Establish a task force (as has been done for other conditions) to review, consolidate and coordinate all US VTE efforts across federal agency stakeholders–CDC, CMS, AHRQ, NIH, FDA, HRSA, Veterans Affairs, Rural Health. Currently, efforts are siloed reflecting a lack of cross-agency collaboration.
- Make a clearly named VTE line-item funding allocation.
- Funds should carry the mandate that they can only be utilized for VTE, prohibiting the ability to divert funds towards other conditions.
- A clear line of reporting and accountability should be implemented with attached funds to ensure results.
- If it is determined that CDC should maintain responsibility for public health prevention of VTE, then a clearly named VTE line-item funding allocation must be made within the same CDC administrative unit that addresses other thrombotic conditions–the National Center for Chronic Disease Prevention and Health Promotion. If another agency is chosen, VTE should be paired with related thrombotic conditions to take advantage of existing expertise.
- Require HHS/CDC to update the National Vital Statistics reporting to add VTE to the current list of 113 select causes of death. Neither the public nor Congress can be aware of the true scope of a condition which is not reported.
 2008 Surgeon General Call to Action report http://www.ncbi.nlm.nih.gov/books/NBK44178/pdf/Bookshelf_NBK44178.pdf
 Selective statistics diminish VTE burden https://bethwaldron.com/selective-statistics-diminish-vte-burden/
 AHRQ, Preventing Hospital Associated Venous Thromboembolism: A Guide for Effective Quality Improvement, October 2015, Publication: 16-0001-EF http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/vtguide/index.html and Greg Maynard, Venous Thromboembolism (VTE) Prevention in the Hospital (Text Descript: Slide Presentation. June 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/vtepresentation/maynardtxt.html
 Berg CJ, Atrash HK, Koonin LM, Tucker M. “Pregnancy-related mortality in the United States 1987-1990”. Obstet Gynecol 1996;88(2):161-7 Also see Marik. P.E. and Plante, L.A. “Venous Thromboembolic Disease and Pregnancy”. New England Journal of Medicine, volume 359, number 19, November 6, 2008, pages 2025-2033.
 Gross, Scott et al The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs, Thrombosis Research, November 24, 2015, http://www.thrombosisresearch.com/article/S0049-3848(15)30209-7/abstract
 Simon Noble “Long-term psychological consequences of symptomatic pulmonary embolism: a qualitative study” BMJ Open http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987719/
CDC FY 2017 Request http://www.cdc.gov/budget/fy2017/congressional-justification.html
 Kaiser Family Foundation U.S. Federal Funding for HIV/AIDS: The President’s FY 2016 Budget Request