Initial Treatment of Patients with Acute Deep Venous Thrombosis: At Home or in the Hospital?

Relatively small randomized trials have shown that home treatment of patients with deep venous thromboses (DVT) is as safe and effective as hospital treatment (Cochrane Database Syst Rev 2007; 3:CD003076). But does that evidence apply to real-world management of DVT? Researchers used an international (mostly European) prospective registry of patients with venous thromboembolism to address this question. The study involved 13,500 outpatients who were diagnosed with acute lower-extremity DVT and treated initially with low-molecular-weight heparin or fondaparinux; about 30% were treated at home, and 70% were admitted to the hospital.

Patients treated at home were, on average, younger and less ill than those admitted to the hospital, but through…