Outpatient-based treatment protocols in the management of venous thromboembolic disease.

摘要: Clinical trial data are demonstrating that the safety and efficacy of treating deep vein thrombosis (DVT) on an outpatient basis with low-molecular weight heparin (LMWH) equal to inpatient care unfractionated (UFH). Moreover, LMWH therapy offers multiple advantages, including improved bioavailability at lower doses, reduced resistance, a longer half-life, potentially, less bleeding. Although these potential advantages acknowledged, patient selection risk stratification criteria for patients being considered discussed frequently; nonetheless, they deserve careful consideration. The protocol utilized by Lovelace Health Systems, staff model health maintenance organization, features outpatient-based DVT treatment program includes exclusionary factors venous thromboembolic disease (VTE). Evidence from clinical findings suggests without absolute can successfully be treated as outpatients. Specific study results show 61% were eligible had fewer recurrences VTE (1.9%) than those comorbid matched who hospitalized traditional UFH previous year (4.1%). These suggest is both safe efficacious in home managed setting when established strategies carefully maintained.