Can all patients with deep vein thrombosis receive low-molecular-weight heparin in an outpatient setting?

Studies have shown subcutaneous low- molecular-weight heparin (LMWH) to be at least as safe and efficacious as intravenous unfractionated heparin (UFH) for the treatment of venous thromboembolism (VTE). Furthermore, unlike UFH, LMWH is administered on a once- or twice-daily basis without monitoring in uncomplicated cases. Consequently, it has been suggested that the large majority of patients with VTE could be treated on an outpatient basis. Exceptions include patients with an increased risk of haemorrhage, pregnant women, children and those with renal insufficiency. Outpatient management would offer economic advantages and be more convenient for both the patient and the hospital staff.