A critical pathway to treat proximal lower-extremity deep vein thrombosis.
To address variation in treatment of deep vein thrombosis (DVT) while maximizing the efficiency and quality of care, our institution developed a critical pathway guideline. This paper presents this critical pathway and the clinical rationale underlying its recommendations. The DVT pathway synthesizes recommendations for all aspects of patient care, including laboratory evaluation at admission, dosing and management of heparin therapy, timing of warfarin initiation, elements of patient education, discharge planning, and anticipated duration of heparinization and hospitalization. Differences among interpretations of the medical literature, patient populations, physician skills, test availability, and other variables make it unlikely that all elements of this pathway would best meet the needs of another institution. Nevertheless, the critical pathway format and the specific contents of this pathway may serve as a useful benchmark for others involved in creating clinical guidelines for this patient population.
Pearson
S D
SD
Section for Clinical Epidemiology, Harvard Community Health Plan Division of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Lee
T H
TH
McCabe-Hassan
S
S
Dorsey
J L
JL
Goldhaber
S Z
SZ
D000203:Activities of Daily Living; D019091:Critical Pathways; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D010353:Patient Education as Topic; D013924:Thrombophlebitis / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
D006493:Heparin