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Comparison between critical pathway guidelines and management of deep-vein thrombosis: retrospective cohort study

N Vucić1, N Lang, S Balić

  • 1Department of Medicine, Holy Ghost General Hospital, Zagreb, Croatia, nvucic@public.srce.hr

Croatian Medical Journal
|June 15, 2000
PubMed

Insights

This study compared deep-vein thrombosis management to critical pathway guidelines. Outcomes showed no significant difference between the critical pathway and conventional treatment approaches for deep-vein thrombosis.

Area of Science:

  • Vascular Medicine
  • Clinical Practice Guidelines
  • Thrombosis Management

Background:

  • Deep-vein thrombosis (DVT) management guidelines aim to standardize care and improve patient outcomes.
  • Critical pathway guidelines offer a structured approach to DVT treatment, but adherence and effectiveness require evaluation.

Purpose of the Study:

  • To compare standard deep-vein thrombosis management with critical pathway practice guidelines.
  • To assess the 6-month treatment outcomes for deep-vein thrombosis patients.

Main Methods:

  • Retrospective cohort study of 172 patients with uncomplicated lower extremity deep-vein thrombosis.
  • Data collected from emergency room registers and medical charts from January 1997 to December 1998.
  • Treatment outcomes evaluated 6 months post-acute event via compressive ultrasonography.

Main Results:

  • Lower initial heparin doses and longer diagnostic assessments were observed compared to guidelines.
  • Therapeutic international normalized ratio was achieved in 78% of patients within 120 hours.
  • Six months post-treatment, 28.9% had complete vein obstruction, 44.1% partial recanalization, and 27% normal findings. Recurrent thrombosis occurred in 10.5%, and pulmonary embolism in 2.6%.

Conclusions:

  • Observed deep-vein thrombosis management deviated from critical pathway guidelines regarding initial heparin dosing and diagnostic timelines.
  • The study employed a combined approach of critical pathway guidelines and conventional treatment.
  • Clinical outcomes did not significantly differ from conventional deep-vein thrombosis treatment methods.
Abstract

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