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. 1998 Sep;15(5):292–293. doi: 10.1136/emj.15.5.292

Outpatient management of deep vein thrombosis.

D F O'Shaughnessy 1, C Tovey 1, A L Miller 1, V O'Neill 1, P S Rana 1, S Akbar 1, M H Thomas 1
PMCID: PMC1343162  PMID: 9785152

Abstract

OBJECTIVE: To assess whether patients with deep vein thrombosis (DVT) could be satisfactorily treated on an outpatient basis with low molecular weight (LMW) heparin and warfarin. DESIGN: A 22 month prospective study of adults attending St Peter's Hospital accident and emergency department with DVT. RESULTS: 1093 patients were referred and assessed; 160 were venogram positive, of which 159 patients between the ages of 22 and 89 years of age have now been treated with LMW heparin as outpatients. Direct liaison with community nurses has minimised the impact on general practitioner workload. CONCLUSIONS: 1272 bed days were saved during this period (an estimated 320,000 pounds). The outpatient treatment of thromboembolism has been shown to be effective and safe.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. A randomised trial of subcutaneous low molecular weight heparin (CY 216) compared with intravenous unfractionated heparin in the treatment of deep vein thrombosis. A collaborative European multicentre study. Thromb Haemost. 1991 Mar 4;65(3):251–256. [PubMed] [Google Scholar]
  2. Arora S., Lam D. J., Kennedy C., Meier G. H., Gusberg R. J., Negus D. Light reflection rheography: a simple noninvasive screening test for deep vein thrombosis. J Vasc Surg. 1993 Nov;18(5):767–772. [PubMed] [Google Scholar]
  3. Brottman P., Propp D., Goldstein C. The use of light reflection rheography to rule out deep venous thrombosis in emergency patients. Am J Emerg Med. 1997 Mar;15(2):215–216. doi: 10.1016/s0735-6757(97)90113-3. [DOI] [PubMed] [Google Scholar]
  4. Hirsh J., Crowther M. Low molecular weight heparin for the out-of-hospital treatment of venous thrombosis: rationale and clinical results. Thromb Haemost. 1997 Jul;78(1):689–692. [PubMed] [Google Scholar]
  5. Hull R. D., Raskob G. E., Pineo G. F., Green D., Trowbridge A. A., Elliott C. G., Lerner R. G., Hall J., Sparling T., Brettell H. R. Subcutaneous low-molecular-weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis. N Engl J Med. 1992 Apr 9;326(15):975–982. doi: 10.1056/NEJM199204093261502. [DOI] [PubMed] [Google Scholar]
  6. Innes G. D., Dillon E. C., Holmes A. Low-molecular-weight heparin in the emergency department treatment of venous thromboembolism. J Emerg Med. 1997 Jul-Aug;15(4):563–566. doi: 10.1016/s0736-4679(97)00095-4. [DOI] [PubMed] [Google Scholar]
  7. Koopman M. M., Prandoni P., Piovella F., Ockelford P. A., Brandjes D. P., van der Meer J., Gallus A. S., Simonneau G., Chesterman C. H., Prins M. H. Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular-weight heparin administered at home. The Tasman Study Group. N Engl J Med. 1996 Mar 14;334(11):682–687. doi: 10.1056/NEJM199603143341102. [DOI] [PubMed] [Google Scholar]
  8. Levine M., Gent M., Hirsh J., Leclerc J., Anderson D., Weitz J., Ginsberg J., Turpie A. G., Demers C., Kovacs M. A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. N Engl J Med. 1996 Mar 14;334(11):677–681. doi: 10.1056/NEJM199603143341101. [DOI] [PubMed] [Google Scholar]
  9. Mitrani A. A., Gonzalez M. L., O'Connell M. T., Guerra J., Harwood R. B., Gardner L. B. Detection of clinically suspected deep vein thrombosis using light reflection rheography. Am J Surg. 1991 Jun;161(6):646–650. doi: 10.1016/0002-9610(91)91248-h. [DOI] [PubMed] [Google Scholar]
  10. Prandoni P., Vigo M., Cattelan A. M., Ruol A. Treatment of deep venous thrombosis by fixed doses of a low-molecular-weight heparin (CY216). Haemostasis. 1990;20 (Suppl 1):220–223. doi: 10.1159/000216180. [DOI] [PubMed] [Google Scholar]
  11. Schafer A. I. Low-molecular-weight heparin--an opportunity for home treatment of venous thrombosis. N Engl J Med. 1996 Mar 14;334(11):724–725. doi: 10.1056/NEJM199603143341110. [DOI] [PubMed] [Google Scholar]
  12. Simonneau G., Sors H., Charbonnier B., Page Y., Laaban J. P., Azarian R., Laurent M., Hirsch J. L., Ferrari E., Bosson J. L. A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. The THESEE Study Group. Tinzaparine ou Heparine Standard: Evaluations dans l'Embolie Pulmonaire. N Engl J Med. 1997 Sep 4;337(10):663–669. doi: 10.1056/NEJM199709043371002. [DOI] [PubMed] [Google Scholar]
  13. Thomas P. R., Butler C. M., Bowman J., Grieve N. W., Bennett C. E., Taylor R. S., Thomas M. H. Light reflection rheography: an effective non-invasive technique for screening patients with suspected deep venous thrombosis. Br J Surg. 1991 Feb;78(2):207–209. doi: 10.1002/bjs.1800780225. [DOI] [PubMed] [Google Scholar]

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