Assessment of Outpatient Treatment of Deep-Vein Thrombosis With Low-Molecular-Weight Heparin

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Abstract
TRADITIONALLY, patients with acute deep-vein thrombosis (DVT) have been treated in the hospital with intravenous unfractionated (UF) heparin for 5 to 7 days, followed by oral anticoagulants for 3 to 6 months.1 Initial hospitalization was considered necessary to stabilize patients, to administer intravenous heparin, and to adjust the dose according to the results of the activated partial thromboplastin time. The need for hospitalization of most patients with DVT has been challenged by the results of 3 recent studies that evaluated low-molecular-weight (LMW) heparins.2-4 Two factors have enabled LMW heparins to be used in the home setting to treat patients with DVT. The first relates to the effectiveness and safety of LMW heparin when administered subcutaneously once or twice daily without laboratory monitoring, and the second, to the observation that many patients with DVT do not require hospital admission.5