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Treatment of deep vein thrombosis: what factors determine appropriate treatment?
1Department of Medicine, McMaster University, Hamilton, Ont. jdouket@mcmaster.ca
Objective:
To identify patients with deep vein thrombosis (DVT) for whom in-hospital treatment should be considered.
Quality Of Evidence:
The literature was searched for studies on outpatient treatment of DVT. Seventeen studies were assessed: seven were randomized controlled trials (level I evidence), and 10 were non-randomized trials (level II evidence).
Main Message:
Four criteria can be used to identify patients with DVT for whom outpatient treatment might not be appropriate: presence of massive DVT, presence of symptomatic pulmonary embolism, high risk of bleeding with anticoagulant therapy, and presence of comorbid conditions or other factors that warrant in-hospital care.
Conclusion:
Four criteria can be used to identify patients with DVT for whom in-hospital treatment should be considered.
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