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Home treatment of patients with cancer-associated venous thromboembolism: an evaluation of daily practice
high risk of adverse events. While home treatment is quite agreeable to cancer patients, studies evaluating the
safety of VTE home treatment in this setting are largely unavailable.
Methods: This was an observational study in patients with cancer-associated VTE. The main outcomes were the
proportion of patients treated at home (hospital discharge < 24 h after diagnosis) and the 3-month incidence of
VTE-related adverse events (major bleeding, recurrent VTE and/or suspected VTE-related mortality) in patients
managed in hospital versus at home.
Results: A total of 183 outpatients were diagnosed with cancer-associated VTE: 69 had deep vein thrombosis
(DVT) and 114 had pulmonary embolism (PE ± DVT). Of those, 120 (66%) were treated at home; this was 83%
for patients with DVT and 55% for patients with PE ( ± DVT). The 3-month incidence of any VTE-related...Show moreBackground: Home treatment of cancer-associated venous thromboembolism (VTE) is challenging due to the
high risk of adverse events. While home treatment is quite agreeable to cancer patients, studies evaluating the
safety of VTE home treatment in this setting are largely unavailable.
Methods: This was an observational study in patients with cancer-associated VTE. The main outcomes were the
proportion of patients treated at home (hospital discharge < 24 h after diagnosis) and the 3-month incidence of
VTE-related adverse events (major bleeding, recurrent VTE and/or suspected VTE-related mortality) in patients
managed in hospital versus at home.
Results: A total of 183 outpatients were diagnosed with cancer-associated VTE: 69 had deep vein thrombosis
(DVT) and 114 had pulmonary embolism (PE ± DVT). Of those, 120 (66%) were treated at home; this was 83%
for patients with DVT and 55% for patients with PE ( ± DVT). The 3-month incidence of any VTE-related adverse
event was 13% in those treated at home versus 19% in the hospitalized patients (HR 0.48; 95%CI 0.22–1.1),
independent of initial presentation as PE or DVT. All-cause 3-month mortality occurred in 33 patients treated as
inpatient (54%) compared to 29 patients treated at home (24%; crude HR 3.1 95%CI 1.9–5.0).
Conclusions: Two-third of patients with cancer-associated VTE - including PE - were selected to start antic-
oagulant treatment at home. Cancer-associated VTE is associated with high rates of VTE-related adverse events
independent of initial in hospital or home treatment. However, home treatment may be a good option for
selected patients with cancer-associated DVT or PE.
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- All authors
- Hendriks, S.V.; Huisman, M.V.; Eikenboom, J.C.J.; Fogteloo, J.; Gelderblom, H.; Meer, F.J.M. van der; Stenger, W.J.E.; Verschoor, A.J.; Versteeg, H.H.; Klok, F.A.
- Date
- 2019
- Volume
- 184
- Pages
- 122 - 128
- ISBN (print)
- 18792472 00493848