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In the last decade, Singapore has seen an eight-fold increase in venous blood clots, the same condition that kills more people in Europe each year than breast cancer, prostate cancer, HIV and road traffic accidents combined.
Despite claiming a record number of lives yearly, this condition is still relatively unknown in Singapore amongst the general public. To raise awareness of this dire situation, TheAsianParent managed to snag an interview with Dr Yang Kuang Ying, Consultant Orthopaedic Surgeon of Orthopaedic & Arthritis Centre.
TheAsianParent (TAP) : Why is there an increase in the number of cases of blood clots (venous thrombosis) in Singapore?
Dr. Yang Kuang Yin (YKY): It has been reported that the incidence of blood clots in Singapore in 1990, 1992 and 2002 is approximately 2.8, 7.9 and 15.8 per 10,000 hospital admissions respectively. However, the increase in the number of cases of blood clots may arise from the better awareness and reporting by the physicians. For example, doctors now actively looked for presence of any venous blood clots in patients after major surgery and this can lead to early and more accurate detection of this problem. Also, increased use of diagnostic tests like ultrasonography also leads to higher rate of detection of the problem.
TAP : Who is at risk here?
Dr. YKY : Some of the risk factors for venous thrombosis are
a. Pregnancy
b. Obesity
c. Smoking
d. Previous history of venous thrombosis
e. Cancer
f. Elderly patients or those who are immobile
g. Major surgeries
TAP : What is the usual treatment for this?
Dr. YKY : The patient is usually treated with various anti-coagulants like Warfarin, low molecular weight heparins and now the newest factor Xa inhibitor.
However, in patients who have been identified to be at risk of developing this problem, we would try to prevent the occurrence with the medications as mentioned above. Some physical modalities like foot and calf pumps have also been show to reduce the occurrence of blood clots.
TAP : Are children at risk as well?
Dr. YKY : Overall, the risk of blood clots is much lower in children than in adults.
TAP : How much pain is a person, who has venous blood clots, looking at?
Dr. YKY : This depends on the location of the venous blood clot. Blood clots in the leg veins usually give moderate pain and swelling in the foot and calf. However, blood clots in the lungs can give severe breathlessness, chest pain and tightness.
TAP : How serious is the situation?
Dr. YKY : The risk of pulmonary embolism is about 0.5-1%. The incidence of death from thromboemolism is approximately 0.1%.
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