The Impact of Risk Stratification of Venous Thromboembolism on Complexity and Site of Management

Abstract Acute venous thromboembolism (VTE), encompassing deep venous thrombosis (DVT) and pulmonary embolism (PE) is a disease state with a high incidence, producing substantial morbidity and mortality. Traditional treatment has been the initiation of parenteral anticoagulation and treatment with a vitamin K antagonist (VKA) such as warfarin. The development of low molecular weight heparin allowed treatment of uncomplicated DVT to be shifted towards the outpatient setting; PE, however, continues to be predominantly managed in the hospital. Non-vitamin K direct oral anticoagulants (NOACs) produce rapid and pedictable anticoagulation as compared to VKAs, and are approved for the treatment and secondary prevention of VTE. In this manuscript we detail risk stratification of the patient with acute VTE, and how patients with low-risk acute VTE may be appropriate for outpatient therapy utilizing a NOAC-based strategy.
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research