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dc.contributor.authorLutsey, Pamela L.
dc.contributor.authorWalker, Rob F.
dc.contributor.authorMaclehose, Richard F.
dc.contributor.authorNorby, Faye L.
dc.contributor.authorEvensen, Line H.
dc.contributor.authorAlonso, Alvaro
dc.contributor.authorZakai, Neil A.
dc.date.accessioned2021-12-28T11:24:35Z
dc.date.available2021-12-28T11:24:35Z
dc.date.issued2021-10-08
dc.description.abstractBackground - Acute outpatient management of venous thromboembolism (VTE), which includes pulmonary embolism (PE) and deep vein thrombosis (DVT), is perceived to be as safe as inpatient management in some settings. How widely this strategy is used is not well documented.<p> <p>Methods and Results - Using MarketScan administrative claims databases for years 2011 through 2018, we identified patients with International Classification of Diseases (ICD) codes indicating incident VTE and trends in the use of acute outpatient management. We also evaluated healthcare utilization and hospitalized bleeding events in the 6 months following the incident VTE event. A total of 200 346 patients with VTE were included, of whom 50% had evidence of PE. Acute outpatient management was used for 18% of those with PE and 57% of those with DVT only, and for both DVT and PE its use increased from 2011 to 2018. Outpatient management was less prevalent among patients with cancer, higher Charlson comorbidity index scores, and whose primary treatment was warfarin as compared with a direct oral anticoagulant. Healthcare utilization in the 6 months following the incident VTE event was generally lower among patients managed acutely as outpatients, regardless of initial presentation. Acute outpatient management was associated with lower hazard ratios of incident bleeding risk for both patients who initially presented with PE (0.71 [95% CI, 0.61, 0.82]) and DVT only (0.59 [95% CI, 0.54, 0.64]).<p> <p>Conclusions - Outpatient management of VTE is increasing. In the present analysis, it was associated with lower subsequent healthcare utilization and fewer bleeding events. However, this may be because healthier patients were managed on an outpatient basis.en_US
dc.identifier.citationLutsey, Walker, Maclehose, Norby, Evensen, Alonso, Zakai. Inpatient versus outpatient acute venous thromboembolism management: Trends and postacute healthcare utilization from 2011 to 2018. Journal of the American Heart Association (JAHA). 2021;10(20)en_US
dc.identifier.cristinIDFRIDAID 1963863
dc.identifier.doi10.1161/JAHA.120.020428
dc.identifier.issn2047-9980
dc.identifier.urihttps://hdl.handle.net/10037/23524
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.journalJournal of the American Heart Association (JAHA)
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710en_US
dc.titleInpatient versus outpatient acute venous thromboembolism management: Trends and postacute healthcare utilization from 2011 to 2018en_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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