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Rivista di Angiologia
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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International Angiology 1998 September;17(3):146-150
Out-patient treatment of acute deep vein thrombosis
Mattiasson I., Berntorp E. *, Bornhov S. °, Lagerstedt C. °°, Lethagen S. *, Persson J. **, Timberg I. ***, Torstensson I. °°°
From the Department of Vascular and Renal Diseases, Lund University, University Hospital, Malmö, Sweden
* Department of Coagulation Disorders, Lund University, University Hospital, Malmö, Sweden
Departments of Medicine at the Hospitals in ° Helsingborg, °° Karlshamn, ** Trelleborg, *** Hässleholm, °°° Kristianstad, Sweden
Background. To assess whether uncomplicated deep vein thrombosis could be treated in an out-patient setting without increasing the frequency of complications, and to de-termine the proportion of patients with deep vein thrombosis, traditionally treated as in-patients at the Departments of Medicine, who are eligible for such treatment.
Methods. In a multicentre study, carried out at six hospitals of varying sizes and serving a population of about 600,000, consecutive patients over 18 years of age, with verified deep vein thrombosis, primarily presented as acute cases at the respective Departments of Medicine, were considered for treatment on an out-patient basis during a 1-year period.
Interventions. Those eligible for out-patient treatment were put on low molecular weight heparin and oral anticoagulants, and scheduled for daily attendance at the out-patient clinic of the respective Dept. of Medicine. Details of any complication were recorded according to a standard check-list. The patients underwent a full check-up at three-month follow-up.
Main outcome measures. Any bleeding event or pulmonary embolism. Progress of thrombosis.
Results. Of 523 patients considered for out-patient treatment, 126 (24%) were excluded according to the defined exclusion criteria, 197 (38%) were treated entirely on an out-patient basis, and another 43 (8%) were initially treated in hospital (median two days) before being transferred to the out-patient setting. Three patients had to be hospitalized for suspected complications, but none of these turned out to be serious. No serious bleeding event or thromboembolic complication was registered.
Conclusions. Uncomplicated acute deep vein thrombosis could be safely treated on an out-patients basis. At least 50% of the patients with this diagnosis, former treated as in-patients at the Depts. of Medicine, are eligible for such treatment.