PMID- 11029476
OWN - NLM
STAT- MEDLINE
DCOM- 20001214
LR  - 20190513
IS  - 1460-2725 (Print)
IS  - 1460-2393 (Linking)
VI  - 93
IP  - 10
DP  - 2000 Oct
TI  - UK patients with deep-vein thrombosis can be safely treated as out-patients.
PG  - 663-7
AB  - Deep-vein thrombosis (DVT) affects approximately 1:1000 people, approximately 750 
      cases/year in a Health Authority of average size. Prior to 1992, patients 
      presenting with DVT were usually admitted for treatment with unfractionated 
      heparin (UFH) over a 5-day period, but pressures on medical admissions have 
      prompted many hospitals to review conditions which could be managed at home. 
      Three different pilot studies commenced in 1996 at three centres in the UK. After 
      6 months, the protocols used were integrated into the normal care plan of the 
      hospital. In total, 5191 patients were assessed, of whom 1347 were either 
      venogram or Doppler ultrasound positive. Overall 1138 (82%) were treated as 
      out-patients, 75% presenting during 'working hours'. Only 12 patients were 
      readmitted, one with a clinically significant PE. Success was attributed to three 
      factors: assignment of a key person as the project co-ordinator; referral of 
      patients directly to permanent, dedicated staff, either on the Medical Admissions 
      Unit (MAU) or the Accident and Emergency (A&E) department; and the introduction 
      of dedicated anticoagulation nurses. In the 6-month period following initial 
      therapy, complications were well below those in previously published studies. 
      Most patients with DVT in the UK can be treated safely and effectively without 
      being admitted to hospital.
FAU - O'Shaughnessy, D
AU  - O'Shaughnessy D
AD  - Department of Haematology, St Peter's Hospital, Chertsey, UK.
FAU - Miles, J
AU  - Miles J
FAU - Wimperis, J
AU  - Wimperis J
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - QJM
JT  - QJM : monthly journal of the Association of Physicians
JID - 9438285
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Ambulatory Care/*organization & administration
MH  - Anticoagulants/therapeutic use
MH  - Female
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - International Normalized Ratio
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission/statistics & numerical data
MH  - Patient Satisfaction
MH  - Phlebography
MH  - Pilot Projects
MH  - Pulmonary Embolism/etiology
MH  - Treatment Outcome
MH  - Ultrasonography, Doppler
MH  - Venous Thrombosis/complications/diagnosis/*therapy
MH  - Warfarin/therapeutic use
EDAT- 2000/10/13 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/10/13 11:00
PHST- 2000/10/13 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/10/13 11:00 [entrez]
AID - 10.1093/qjmed/93.10.663 [doi]
PST - ppublish
SO  - QJM. 2000 Oct;93(10):663-7. doi: 10.1093/qjmed/93.10.663.