Treatment of deep vein thrombosis: what factors determine appropriate treatment?

OBJECTIVE: To identify patients with deep vein thrombosis (DVT) for whom in-hospital treatment should be considered. QUALITY OF EVIDENCE: The literature was searched for studies on outpatient treatment of DVT. Seventeen studies were assessed: seven were randomized controlled trials (level I evidence), and 10 were non-randomized trials (level II evidence). MAIN MESSAGE: Four criteria can be used to identify patients with DVT for whom outpatient treatment might not be appropriate: presence of massive DVT, presence of symptomatic pulmonary embolism, high risk of bleeding with anticoagulant therapy, and presence of comorbid conditions or other factors that warrant in-hospital care. CONCLUSION: Four criteria can be used to identify patients with DVT for whom in-hospital treatment should be considered.