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Editor's Correspondence
March 27, 2000

Eligibility for Outpatient Treatment With Low-Molecular-Weight Heparin in Venous Thromboembolism

Arch Intern Med. 2000;160(6):869-870. doi:

Recently, low-molecular-weight heparin (LMWH) has emerged as a new alternative to unfractionated heparin for the treatment of venous thromboembolic diseases. It possesses several advantages, such as longer half-life and predictable anticoagulant response,1 and its use in outpatient settings can substantially reduce the cost of care.2 In trials investigating the efficacy and safety of LMWH treatment in outpatient settings, different exclusion criteria for patient selection were introduced. Some studies excluded more than half of the patients.3,4 In a recent issue of the ARCHIVES, Wells et al5 proved that more than 80% of their patients could be treated safely and effectively as outpatients. The Albert Einstein Medical Center, Philadelphia, Pa, is a tertiary-care hospital, providing care in an urban setting. The eligibility rate for outpatient LMWH therapy in an institution such as ours is unknown.