UK patients with deep‐vein thrombosis can be safely treated as out‐patients
Open Access
- 1 October 2000
- journal article
- research article
- Published by Oxford University Press (OUP) in QJM: An International Journal of Medicine
- Vol. 93 (10), 663-667
- https://doi.org/10.1093/qjmed/93.10.663
Abstract
Deep‐vein thrombosis (DVT) affects ∼1:1000 people, ∼750 cases/year in a Health Authority of average size. Prior to 1992, patients presenting with DVT were usually admitted for treatment with unfractionated heparin (UFH) over a 5‐day period, but pressures on medical admissions have prompted many hospitals to review conditions which could be managed at home. Three different pilot studies commenced in 1996 at three centres in the UK. After 6 months, the protocols used were integrated into the normal care plan of the hospital. In total, 5191 patients were assessed, of whom 1347 were either venogram or dopples ultrasound positive. Overall 1138 (82%) were treated as out‐patients, 75% presenting during ‘working hours’. Only 12 patients were readmitted, one with a clinically significant PE. Success was attributed to three factors: assignment of a key person as the project co‐ordinator; referral of patients directly to permanent, dedicated staff, either on the Medical Admissions Unit (MAU) or the Accident and Emergency (A&E) department; and the introduction of dedicated anticoagulation nurses. In the 6‐month period following initial therapy, complications were well below those in previously published studies. Most patients with DVT in the UK can be treated safely and effectively without being admitted to hospital.Keywords
This publication has 10 references indexed in Scilit:
- Outpatient management of deep vein thrombosis.Emergency Medicine Journal, 1998
- A Comparison of Low-Molecular-Weight Heparin with Unfractionated Heparin for Acute Pulmonary EmbolismNew England Journal of Medicine, 1997
- Low-Molecular-Weight Heparin in the Treatment of Patients with Venous ThromboembolismNew England Journal of Medicine, 1997
- Low Molecular Weight Heparin for the Out-of-Hospital Treatment of Venous Thrombosis: Rationale and Clinical ResultsThrombosis and Haemostasis, 1997
- A Comparison of Low-Molecular-Weight Heparin Administered Primarily at Home with Unfractionated Heparin Administered in the Hospital for Proximal Deep-Vein ThrombosisNew England Journal of Medicine, 1996
- Treatment of Venous Thrombosis with Intravenous Unfractionated Heparin Administered in the Hospital as Compared with Subcutaneous Low-Molecular-Weight Heparin Administered at HomeNew England Journal of Medicine, 1996
- Treatment of Deep Venous Thrombosis With Low-Molecular-Weight HeparinsArchives of Internal Medicine, 1995
- Subcutaneous Low-Molecular-Weight Heparin Compared with Continuous Intravenous Heparin in the Treatment of Proximal-Vein ThrombosisNew England Journal of Medicine, 1992
- Low molecular weight heparinBlood, 1992
- Anticoagulants in venous thromboembolism.BMJ, 1988