The Journal of the American Osteopathic Association, 2000/11, 100(11 Suppl):S17-21. doi: 10.7556/jaoa.2000.20007, type of study: ,art,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

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Keywords:

ambulatory care [15]
anticoagulants [1]
article [2635]
evidence-based medicine [150]
low-molecular-weight heparin [1]
patient discharge [1]
time factors [7]
venous thrombosis [3]
warfarin [1]

Abstract:

The past 10 years have seen dramatic changes in how we treat deep vein thrombosis (DVT). A decade ago, we would treat patients for 5 days with intravenous heparin and then start warfarin sodium therapy and continue administering both anticoagulants for another 5 to 7 days. In the early 1990s, we started warfarin therapy at the same time heparin was begun and decreased the hospital stay from 10 to 14 days to 5 to 7 days. With the development of low-molecular-weight heparin and the approval for use as outpatient treatment, patients are now spending 1 to 2 days in the hospital, and many times, they are not admitted. A case scenario (in italics) is integrated into this review to illustrate the cost-effective application of an evidence-based approach.