Protocollaire thuisbehandeling van diepe veneuze trombose in een been: effectief en veilig in de dagelijkse praktijk

To evaluate a standard protocol for ambulant treatment of patients with deep venous thrombosis (DVT) in a leg with low molecular weight heparins (LMWH).

Design

Prospective.

Method

A protocol was established within a regional context which provided for all patients in or around Veghel, the Netherlands, with demonstrated DVT in the period 1 March 1997-31 July 1999 to receive ambulant treatment with LMWH and oral anticoagulants. After diagnosing the treatment was started in the emergency department of the Sint Joseph Hospital in Veghel, the subsequent LMWH injectons were administered by the general practitioner in his practice.

Results

Of the 130 patients with demonstrated DVT, six were hospitalized because of pulmonary embolism, carcinoma or pregnancy, while 124 (95) were eligible for ambulant treatment (56 males with a median age of 57 years (range 16-98) and 68 females with a median age of 51 years (18-89). During the acute period of LMWH treatment, none of the 124 patients developed a recurrence of thrombosis, pulmonary embolism or major haemorrhage. During 3 months’ follow-up one patient developed a thrombosis in the other leg, this patient died after 2 months from disseminated carcinoma of the colon.

Conclusion

Ambulant treatment of patients with DVT of the leg with LMWH in a daily practice setting is feasible and can be carrried out effectively and safely in 95 of the patients in a regional organization.