Systematic Review of Real-World Studies Evaluating Characteristics Associated With or Programs Designed to Facilitate Outpatient Management of Deep Vein Thrombosis

Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):301S-313S. doi: 10.1177/1076029618811082. Epub 2018 Nov 14.

Abstract

Select patients with acute deep vein thrombosis (DVT) can be managed as outpatients. We sought to conduct a systematic review of real-world studies describing either (1) the clinical characteristics associated with outpatient DVT treatment in all-comers or (2) emergency department (ED) programs designed to facilitate outpatient DVT treatment. MEDLINE and SCOPUS were searched (January 1, 2012, to May 1, 2018) to identify citations meeting the aforementioned criteria. Twenty-one real-world studies were included. The proportion of all-comer patients with DVT managed as outpatients was ≤50% in 11 of 15 studies. With the exception of younger age, no characteristics were consistently associated with outpatient treatment across the 13 studies reporting these characteristics. We identified 8 studies describing ED programs aimed at facilitating DVT outpatient treatment, all of which provided education and included measures to encourage early outpatient follow-up after ED discharge. In conclusion, the proportion of patients with DVT managed as outpatients across real-world studies was low. Several ED programs aimed at facilitating this treatment have been described. It is possible that programs similar to these will increase the proportion of patients with DVT that can be safely managed as outpatients.

Keywords: deep vein thrombosis; home; outpatient; patient discharge; venous thrombosis.

Publication types

  • Systematic Review

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Ambulatory Care*
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Humans
  • Outpatients*
  • Venous Thrombosis / blood
  • Venous Thrombosis / drug therapy*

Substances

  • Anticoagulants