What Causes Blood Clots When You Are in the Hospital?

This article is for people who are at risk for getting a blood clot while they are in the hospital, or anyone who wants to learn more about blood clots. The goal of this patient education activity is to improve knowledge of the causes of blood clots in hospitalized patients in order to help prevent them during hospital stay and post-hospital discharge.

You will learn about:

• Who might get a blood clot while in the hospital

• Ways to prevent a blood clot while in the hospital

• Ways to prevent a blood clot after discharge from the hospital

• How to know if you have a blood clot

A blood clot is a clump of blood, platelets, cholesterol, and other things. It can form if blood is too thick or moves too slowly through blood vessels, or if there is damage to the skin or a blood vessel. If you're staying in the hospital for an illness, you may not be moving around a lot and it may increase your risk (chance) of getting a blood clot.

Usually, blood clots can be good as they help stop bleeding, like when you have a cut on your finger. But having blood clots can also be bad. They can get stuck in a blood vessel and block blood flow to places in your body, like the lungs, arms, and legs, and sometimes, the heart or brain.

Having any of these risk factors may increase your chances of developing a blood clot while you are in the hospital:

• Age 60 years or older

• Had a blood clot in the past (including a heart attack or stroke)

• Stayed in the intensive or coronary care unit (ICU or CCU)

• Could not move on your own for 3 or more days in a hospital bed

• Have cancer or received chemotherapy

• Paralyzed below the waist

• Have a health condition that increases the risk of blood clots

• Had a major surgery (hip, knee, heart)

• Very overweight (obese)

To find out your risk for getting a blood clot, your doctor or another healthcare professional will ask you questions about your age, medical history, medicines you are taking, and your lifestyle, while you are in the hospital and again before you go home.

Your answers will help your doctor decide which method to use to prevent blood clots while you are in the hospital and after you are discharged from the hospital.

For someone with a lower risk of getting a blood clot, light physical activity or a compression device can help improve blood flow and prevent blood clots from forming.

• Light physical activity such as walking in the hospital hallway and doing foot and leg exercises as often as possible is helpful, but only as instructed by your doctor or a healthcare professional.

• Compression devices keep blood moving between the legs and heart. Cuffs are placed around the legs and filled with air. They squeeze the legs (just like a blood pressure cuff), deflate, and start over again.

For someone with a high risk of getting a blood clot and a low risk of bleeding, blood thinners or anti-clotting medicines can help prevent blood clots from forming.

• Heparin is a blood thinner that is commonly used in the hospital. It is given as a shot 2 to 3 times a day. Some people may have side effects like stomach pain, joint pain, swelling, or bleeding.

• Low-molecular-weight heparin is another type of heparin that is given as 1 shot a day. Some people experience mild irritation, pain, bruising, redness, and swelling with the injections.

Blood clots can happen up to 3 months after you leave the hospital. When you are discharged from the hospital, your doctor may ask you to take a medicine to prevent a blood clot.

There is now a pill called rivaroxaban (Xarelto®) that you may start while you are in the hospital and then continue taking when you go home. Some patients may experience mild bleeding, like a nosebleed or gum bleeding, while taking this medicine, but this is manageable.

To prevent blood clots, it is important to keep taking the blood thinner as prescribed and for as long as your doctor asks you to.

Here are some tips to help prevent a blood clot after you are discharged from the hospital:

• Move around, do not sit or stand in one place for more than 1 hour

• While you are sitting, flex your calves, ankles, and thighs from time to time to keep blood flowing

• While sitting or lying down, raise your feet up

• Be physically active for at least 20 minutes, 3 to 4 times a week

• Stay hydrated, drink 64 ounces of water a day

• Do not smoke

• Limit alcohol intake

• Wear compression stockings while flying, especially for flights that are 4 hours or more

Call for emergency help if you have any of these symptoms after leaving the hospital:

Blood Clot in Arms or Legs	Blood Clot in the Lungs
• Pain, throbbing, cramping or tenderness • Swelling • Redness or discoloration • Warmth	• Unexplained shortness of breath • Fast breathing • Sharp chest pain (may hurt more when you take a deep breath) • Fast heart rate • Lightheadedness or passing out • Coughing up blood

• Am I at risk for a blood clot after leaving the hospital?

• What should I do to prevent blood clots?

• What signs and symptoms should I look for?

• When should I get emergency help?

• Which blood thinner is right for me?

Congratulations!

You have successfully completed the program What Causes Blood Clots When You Are in the Hospital?

View Additional Materials

View Additional Materials on this topic that you may find useful:

Centers for Disease Control and Prevention: Understanding Blood Clots

World Thrombosis Day: Patients' Rights

World Thrombosis Day: What to Know Before Going to the Hospital

World Thrombosis Day: Personal Stories