PMID- 10493228
OWN - NLM
STAT- MEDLINE
DCOM- 19991105
LR  - 20051116
IS  - 0957-5235 (Print)
IS  - 0957-5235 (Linking)
VI  - 10 Suppl 2
DP  - 1999 Aug
TI  - Building effective prophylaxis of deep vein thrombosis in the outpatient setting.
PG  - S29-35
AB  - Perioperative prophylaxis of venous thromboembolism (VTE) usually coincides with 
      the duration of hospital stay, typically lasting between 5 and 14 days. However, 
      mounting evidence indicates that the risk of postoperative VTE persists for at 
      least five weeks after orthopaedic surgery and six weeks following general 
      surgery, suggesting that prolonged prophylaxis may reduce the burden of 
      thromboembolic complications. As interest in extending prophylaxis grows, 
      however, economic pressures and patient preferences are contributing to ever 
      shorter hospital stays, giving rise to an exploration of administering prolonged 
      prophylaxis to ambulatory patients at home. Effective outpatient prophylaxis for 
      VTE must be safe, simple to use and convenient for patients to maximize 
      compliance. Low-molecular-weight heparins (LMWHs) are at least as safe and 
      effective as standard low-dose unfractionated heparin (UFH) in preventing 
      thromboembolic events, and can be administered subcutaneously at a fixed daily 
      dose without monitoring. Clinical studies in patients with total hip replacement 
      have demonstrated that LMWHs, administered at home once daily for up to four 
      weeks following hospital discharge, are safe and well-tolerated and significantly 
      reduce the incidence of post-discharge deep vein thrombosis. Due to the high 
      costs of treating thromboembolic complications and post-thrombotic syndrome, 
      appropriately targeted prolonged thromboprophylaxis may be cost-effective.
FAU - Agnelli, G
AU  - Agnelli G
AD  - Institute of Internal and Vascular Medicine, University of Perugia, Italy. 
      agnellig@unipg.it
FAU - Taliani, M R
AU  - Taliani MR
FAU - Verso, M
AU  - Verso M
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Blood Coagul Fibrinolysis
JT  - Blood coagulation & fibrinolysis : an international journal in haemostasis and 
      thrombosis
JID - 9102551
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Ambulatory Care/economics/methods
MH  - Cost-Benefit Analysis
MH  - Disease Management
MH  - Heparin/administration & dosage/therapeutic use
MH  - Humans
MH  - Postoperative Care/economics
MH  - Venous Thrombosis/*prevention & control/therapy
RF  - 38
EDAT- 1999/09/24 00:00
MHDA- 1999/09/24 00:01
CRDT- 1999/09/24 00:00
PHST- 1999/09/24 00:00 [pubmed]
PHST- 1999/09/24 00:01 [medline]
PHST- 1999/09/24 00:00 [entrez]
PST - ppublish
SO  - Blood Coagul Fibrinolysis. 1999 Aug;10 Suppl 2:S29-35.