NICE releases updated guidelines for management of VTE
National Institute for Health and Care Excellence (NICE) has released an updated version of its guideline on the diagnosis and management of VTE (original version 2012, minor update 2015). Venous thromboembolism in adults: diagnosis, management and thrombophilia testing guidelines by NICE will be relevant to primary care and secondary generalist physicians.
Venous thromboembolic (VTE) disease is a continuing global health burden with serious mortality, morbidity, and health economic consequences.1 The one year case fatality rate of definite or probable VTE has been estimated at 23%. Approximately 1 to 2 of every 1000 adults in the worldwide population will be diagnosed with VTE annually, with higher incidence rates in those over 70 (2 to 7/1000) and over 80 (3 to 12/1000).
The new guidelines now officially support the use of age adjusted d-dimer strategies for both DVT/PE and the use of the Pulmonary Embolism Rule Out Criteria (PERC).
What's updated in this guidance?
If clinical suspicion of pulmonary embolism is low, consider using the pulmonary embolism rule-out criteria (PERC) to help determine whether any further investigations for pulmonary embolism are needed
In people over 50, consider using an age-adjusted D-dimer
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