Outcome Evaluation

• Achieve optimal outcomes by: (a) preventing the occurrence of VTE in patients who are at risk, (b) administering effective treatments in a timely manner to patients who develop VTE, (c) preventing treatment-related complications, and (d) reducing the likelihood of long-term complications including recurrent events.

FIGURE 10-11. Treatment of VTE. (LMWH, low-molecular weight heparin; PE, pulmonary embolism; SBP, systolic blood pressure; UFH, unfractionated heparin; VTE, venous thromboembolism.) (From Haines ST, Witt DM, Nutescu EA. Venous thromboembolism. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy: A Pathophysiologic Approach, 7th ed. New York: McGraw-Hill; 2008:357.)

FIGURE 10-11. Treatment of VTE. (LMWH, low-molecular weight heparin; PE, pulmonary embolism; SBP, systolic blood pressure; UFH, unfractionated heparin; VTE, venous thromboembolism.) (From Haines ST, Witt DM, Nutescu EA. Venous thromboembolism. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy: A Pathophysiologic Approach, 7th ed. New York: McGraw-Hill; 2008:357.)

• Given that VTE is often clinically silent and potentially fatal, strategies to increase the widespread use of prophylaxis have the greatest potential to improve patient outcomes. Thus, relying on the early diagnosis and treatment of VTE is unacceptable because many patients will die before treatment can be initiated.

• Effective VTE prophylaxis programs screen and identify all patients at risk, determine each patient's level of risk, and select and implement regimens that provide sufficient protection for the level of risk.

Table 10-11 Duration of Anticoagulation Therapy for the Treatment of VTE

DurAlton of Thwapy

P«tl«nt diindaiitict

Drug

f Months]

Comments

FilH t'wiiotk.'yi VTt SHKOftlny 10 ■) transient

Wixi^iri

}

RMOmihCmttafon jpplici UJ tx*hpi(.™r™i jnd

Offi'vMSlbietillJi fat (01

calf vein thrombosis

Fin-1 episocie, unprovoked VTE

Waff* in

Aftejsti

Wtei 3 months of therapy, cvalujie patient for risk-benefit of tong-drm [hwpy

Firsl episode, UJipiovoked prorimal WT or

Long term

If ink. factors for bleeding are absent and good

untrOWAftJ PE

iint<Mi*jL.in( monitoring ^«hit^ed

Firsl episode of VTl and cancer

LMWH

LMV/H isiecommendod otir waifann foi tlie irmiaHi months Sttoihiucnt ihtfipy (Dcv^ind iiw.L mirijl 6 monitor u mikdncer is resoVid is rciomnwixJwJ with wai foi in or LMWH

Second episode of unpovcked VT£

Vti Ma- in

long term

OJT, dedp vein thrombosis; LMWH low-molecular weight heparins; PEr pulmonary enrbohsiiK VTE, venous 1 hdomboembolisin. Fpom Hef. If.

OJT, dedp vein thrombosis; LMWH low-molecular weight heparins; PEr pulmonary enrbohsiiK VTE, venous 1 hdomboembolisin. Fpom Hef. If.

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