Publisher's Synopsis
Over the last several decades we have seen dramatic drops in the mortality rates from cardiovascular disease, the leading cause of death in this country. Yet challenges remain, and certain areas of medicine have not seen improvements. One of the biggest challenges relates to blood clots in the legs (a disease known as deep vein thrombosis or DVT), which can not only cause pain, swelling, and other discomfort, but also frequently travel to the lungs, causing a potentially fatal pulmonary embolism (PE). The best estimates indicate that 350,000 to 600,000 Americans each year suffer from DVT and PE, and that at least 100,000 deaths may be directly or indirectly related to these diseases. This is far too many, since many of these deaths can be avoided. Because the disease disproportionately affects older Americans, we can expect more suffering and more deaths in the future as our population ages-unless we do something about it. The Institute of Medicine has classified the failure to provide appropriate screening and preventive treatment to hospitalized, at-risk patients as a medical error, and the Agency for Healthcare Research and Quality has ranked the provision of such preventive treatment as one of the most important things that can be done to improve patient safety. Proven, effective measures are available to prevent and treat DVT and PE in high-risk individuals. Yet today the majority of individuals who could benefit from such proven services do not receive them. Too few Americans know what DVT or PE is, how to recognize the symptoms, or how to talk with their clinicians about prevention, diagnosis, and treatment. Too few health care professionals are aware of the evidence-based practices for identifying high-risk patients and providing preventive, diagnostic, or therapeutic services. Additionally, as in any area of medicine, gaps still remain in our knowledge about how best to care for certain patient subpopulations, and further research is needed. This Surgeon General's Call to Action represents an opportunity for multiple stakeholders to come together in a coordinated effort to reverse the projected trends and to dramatically reduce the pain and suffering caused by DVT and PE in this nation through specific steps in communication, action, research and evaluation. With the involvement of individuals, families, communities, all aspects of research and health care systems, organizations, governments, and the media, we can bring better health to this country.
