Office Management of Deep Venous Thrombosis in the Elderly

Laurie G. Jacobs, Henny H. Billett

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Deep venous thrombosis is common in the elderly. Diagnosis and management are now a part of office practice. As signs and symptoms are inconsistent and nonspecific, diagnostic testing is necessary. For patients with a low clinical probability, a normal D-dimer result can rule out disease. For patients with a high clinical suspicion or an elevated D-dimer, duplex ultrasonography may confirm the diagnosis. Anticoagulation, usually with low-molecular-weight heparin, should begin on suspicion and continue, along with warfarin, until the international normalized ratio is therapeutic. Arrangements for the initial daily injections can be made with a visiting nurse. Treatment should continue for at least 3 months, when a risk-versus-benefit analysis for continuing anticoagulation should be undertaken. Therapy may be discontinued for thromboses associated with a reversible risk factor or for patients in whom anticoagulant management was unstable or complicated by bleeding. A persistently high D-dimer result or evidence of residual clot on repeat duplex ultrasonography may support continuation. For all patients, the use of compression stockings to prevent the post-thrombotic syndrome is recommended.

Original languageEnglish (US)
Pages (from-to)904-906
Number of pages3
JournalAmerican Journal of Medicine
Volume122
Issue number10
DOIs
StatePublished - Oct 2009

Fingerprint

Office Management
Venous Thrombosis
Ultrasonography
Compression Stockings
Community Health Nurses
International Normalized Ratio
Low Molecular Weight Heparin
Warfarin
Anticoagulants
Signs and Symptoms
Thrombosis
Therapeutics
Hemorrhage
Injections
fibrin fragment D

Keywords

  • Anticoagulation
  • Deep venous thrombosis
  • Diagnosis and treatment

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Office Management of Deep Venous Thrombosis in the Elderly. / Jacobs, Laurie G.; Billett, Henny H.

In: American Journal of Medicine, Vol. 122, No. 10, 10.2009, p. 904-906.

Research output: Contribution to journalArticle

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