EKOS Intervention For Septic Patients with VTE: Mortality Rates at Morristown Medical Center, Southeast Alabama Medical Center, and MultiCare Good Samaritan Hospital

In Ekos, Venous Thromboembolism (VTE)

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By: Saparja Nag Apr. 10, 2018

The EKOS system, by BTG Interventional Medicine, offers an innovative treatment option for patients with pulmonary embolisms by combining thrombolytic medicines and ultrasound waves to dissolve blood clots. The EkoSonic™ Endovascular system utilizes Acoustic Pulse Thrombolysis™ to target and thin fibrin in order to dissolve a blood clot, which occurs by making the fibrin more porous and creating a pressure gradient to deliver the thrombolytics deeper within the clot. This therapeutic system offers multiple benefits over other venous thromboembolism (VTE) interventions including lowered risk of bleeding and other complications by targeting the clot specifically without affecting surrounding vessels, valves, or walls, and lower dosage requirements compared to both catheter-directed drug delivery and traditional systemic delivery via the circulatory system. The use of the EkoSonic™ Endovascular system provides a number of advantages over more traditional treatment options of VTE and thus may significantly affect mortality rates for certain conditions.

Dexur's VTE quality outcomes dashboard allows for analysis of mortality rates at various hospitals around the country based on the primary condition patients are diagnosed with and if they also present with VTE. This study examines patients diagnosed with severe sepsis or septicemia at three major hospitals: Morristown Medical Center in New Jersey, Southeast Alabama Medical Center in Alabama, and MultiCare Good Samaritan Hospital in Washington. These patients were categorized under DRG-871, defined as septicemia or severe sepsis without mechanical ventilation >96 hours with major complication or comorbidity. The mortality rate for DRG-871 patients at these three hospitals were calculated for those who presented with VTE and those who did not. The difference between these mortality rate metrics demonstrates a gap in medical care where the EkoSonic™ system may make an impact.

Of the three hospitals analyzed, Morristown Medical Center had the lowest mortality rate for DRG-871 patients with VTE at 19% and the smallest difference between patients with VTE and without VTE of 4%. Sepsis patients at Southeast Alabama Medical Center had a mortality rate of roughly 16% when VTE was not also present, but a rate of 23% when VTE was found for a difference of 7%. MultiCare Good Samaritan Hospital's patients with septicemia or severe sepsis without VTE had a mortality rate of 13%, which jumped 8% to a mortality rate of 21% for patients with VTE. The differences in mortality rates between sepsis patients with and without VTE represent potential space where the EkoSonic™ system may be effective in dissolving blood clots, therefore impacting overall mortality rates of patients with VTE.

Scientific studies have also discovered a correlation between sepsis and VTE incidence rates. One significant study from 2015 conducted by researchers at University of Utah found that patients diagnosed with sepsis may be inherently more likely to develop VTE as a result of systemic inflammation, even when extensive thromboprophylaxis guidelines are followed. They proposed that "sepsis induces a marked proinflammatory and prothrombotic systemic milieu," which may explain high incidence rates of VTE among sepsis patients. Due to their findings they recommend that "clinicians should maintain a low threshold for evaluating the development of VTE in patients with severe sepsis and septic shock."

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Total DRG-871 discharge volume, DRG-871 with VTE discharge volume, mortality rates with and without VTE for Morristown Medical Center, Southeast Alabama Medical Center, and MultiCare Good Samaritan Hospital
Difference in mortality rates with and without VTE for Morristown Medical Center, Southeast Alabama Medical Center, MultiCare Good Samaritan Hospital, respective states, and nation

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ABOUT THE AUTHOR

Saparja Nag

Saparja is a healthcare journalist with a particular interest in how medicine can and should affect health policy. She has extensive experience as a health educator and research scientist in biochemistry. She also enjoys running, cooking elaborate meals, and then eating elaborate meals. Saparja received a Bachelors of Arts in Biochemistry from Vassar College.