[Heparin in deep venous thrombosis of the leg--effectiveness and safety].
The aim of this retrospective study was to evaluate the adequacy of heparin treatment in deep venous thrombosis and the rate of symptomatic complications under the everyday conditions of a hospital. The investigation was carried out in 200 consecutive patients, 117 women and 83 men (mean age 61 +/- 17 years) with verified deep venous thrombosis. Na-heparin was given over 12 +/- 7 days; the initial daily dosage amounting to 31700 IU followed by a maintenance dosage of 36150 IU. 153 patients were treated exclusively or predominantly by the subcutaneous route (3 times daily) and 47 by continuous i.v. infusion. In the i.v. group 47% of thrombin times (TT) were prolonged to values exceeding 48 seconds in comparison with only 39% in the subcutaneous group (p less than 0.001). 34 patients developed thromboembolic complications (pulmonary embolism in 33), causing death in 13 cases. Patients with thromboembolic complications differed from those without in respect to the rate of a therapeutically prolonged TT (10% vs 44%, p less than 0.001) and signs of pulmonary embolism on admission (44% vs 8%, p less than 0.001), but not with respect to heparin dosage. Thromboembolic complications appeared in only 3 patients receiving i.v. therapy. Patients with thrombosis of the iliac or femoral veins appeared twice as likely to develop pulmonary embolism than patients with calf vein thrombosis (n.s.). Bleeding was registered in 11 patients. One patient died from retroperitoneal haemorrhage. At the time of bleeding 10 patients were on subcutaneous heparin and in 9 patients the TT was prolonged to over 2 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
Gatterer
E
E
II. Medizinische Abteilung, Krankenanstalt Rudolfstiftung, Wien.
Stöllberger
C
C
Slany
J
J
Stöberl
C
C
Jaksch
J
J
D003692:Delayed-Action Preparations; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy; D012189:Retrospective Studies; D013924:Thrombophlebitis / Q000188:drug therapy*
D003692:Delayed-Action Preparations; D006493:Heparin
Heparin bei tiefer Beinvenenthrombose--Effizienz und Sicherheit.