A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis

Article Abstract:

Low-molecular-weight heparin may offer safe and effective home treatment for patients with deep leg vein clots. Low-molecular-weight heparin requires neither intravenous administration nor close follow up because its anticlotting properties are more predictable. Researchers randomly assigned 500 patients with deep-vein clots and no other complications to either the traditional in-hospital intravenous treatment with standard heparin or twice daily injections of low-molecular-weight heparin administered by the patient or a family member at home. During the 3-month follow-up period, 5% of the home treatment group versus 7% of the hospital group experienced a recurrent, symptom-causing clot. Two patients in the hospital group had pulmonary embolisms and both died. Hemorrhages occurred in 2% of the home treatment group versus 1% of the hospital group, and minor bleeding occurred in six patients in each group. Two patients in the home treatment group died of hemorrhages. Hospital stay in the home treatment group averaged 1.1 days versus 6.5 days in the hospital treatment group.

Health aspects, Drug therapy, Thrombosis, Deep vein, Deep vein thrombosis, Heparin

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Use of a Clinical Model for Safe Management of Patients with Suspected Pulmonary Embolism

Article Abstract:

A model that categorizes people as having a low, moderate, or high risk of pulmonary embolism appears to be helpful when interpreting ventilation-perfusion lung scans. Pulmonary embolism occurs when a blood clot forms in the legs and travels to the lungs. Ventilation-perfusion lung scans are often used to diagnose pulmonary embolism. In a study of 1,239 patients who had a ventilation-perfusion lung scan, only 3% of those with a low risk actually had pulmonary embolism as determined by the lung scan compared to 28% with a moderate risk and 78% of those with a high risk.

Diagnosis, Pulmonary embolism, Ventilation-perfusion ratio, Lung ventilation-perfusion scan

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