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• W2061760488 abstract "Home vs. inpatient treatment for deep vein thrombosis. Othieno R., Abu Affan M. & Okpo E. (2007) Home vs. inpatient treatment for deep vein thrombosis. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD003076. DOI: 10.1002/14651858.CD003076.pub2. Date of most recent substantive amendment: 22 May 2007. The full review report, including references, can be accessed using the digital object identifier, doi: 10.1002/14651858.CD003076.pub2. What is the effectiveness of home treatment compared with inpatient treatment for deep vein thrombosis? Cochrane review containing a meta-analysis of trials. Deep vein thrombosis (DVT) is a condition caused by the formation of a blood clot in a deep vein, commonly in the leg. It is often associated with malignancy and may occur after surgery and/or trauma or because of immobility. Complications include swelling, tenderness and the possibility of death if a blood clot happens to dislodge and travel to the lungs, causing a pulmonary embolism. Patients with DVT are treated with blood thinners such as unfractionated heparin (UH). UH is administered intravenously, with laboratory monitoring, for approximately 5 days in the hospital setting. Low molecular weight heparin (LMWH) has been developed to treat DVT and has been shown to be as effective and safe as UH and can be administered subcutaneously once a day at home. A systematic review was performed to compare home treatment with LMWH to inpatient treatment with UH or LMWH. Six randomized controlled trials were included in the review, with 1708 participants. All six studies were assessed as low quality, with problems such as high exclusion rates, partial hospitalization and the comparison of two different treatments (UH in hospitals to LMWH in homes) affecting all studies. Meta-analysis was performed where possible. Six studies showed that patients at home who were treated with LMWH, compared with hospitalized patients treated with UH or LMWH, had a statistically significantly lower rate of recurrence of venous thromboembolism. Meta-analysis suggested that minor bleeding was more likely to occur in the home situation rather than in hospital, although this was not statistically significant. Results from the six studies indicated a tendency for major bleeding to occur more often in the hospital rather than the home setting. However, this was not statistically significant. Mortality was higher in the hospitalized compared with the home group, although this finding was not statistically significant. Possible cost reductions were shown for patients being treated in the home setting compared with hospital patients, largely because of the costs associated with hospitals. Although it has been shown that home treatment with LMWH compared with inpatient treatment with either LMWH or UH was more effective for recovering from DVT, the studies assessed were of low methodological quality. Limited evidence showed that there is a reduction in costs for patients treated at home compared with those treated in hospital, largely because of hospitalization costs. Further matters relating to DVT treatment need to be addressed, such as exclusion criteria for home treatment, screening tests and administration of LMWH when DVT is suspected but not confirmed. MUNN Z. (2008) Review Summaries: Othieno R., Abu Affan M. & Okpo E. (2007) Home vs. inpatient treatment for deep vein thrombosis. Journal of Advanced Nursing 64(6), 576–577." @default.
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• W2061760488 title "Home vs. inpatient treatment for deep vein thrombosis" @default.
• W2061760488 doi "https://doi.org/10.1111/j.1365-2648.2008.04887.x" @default.
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