The venous side: current directions in anticoagulant therapy.
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.
Kaatz
S
S
Anticoagulation Clinics, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA. skaatz1@hfhs.org
D000553:Ambulatory Care; D000925:Anticoagulants / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D013997:Time Factors; D020246:Venous Thrombosis / Q000188:drug therapy*; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin