OBJECTIVES: Uncomplicated deep vein thrombosis (DVT) can be treated in the outpatient setting with oral anticoagulants. However, emergency department (ED) visits for uncomplicated DVT are often managed through hospitalization initially rather than ED discharge with appropriate anticoagulation and outpatient follow-up. Providers have varying degrees of comfort with outpatient DVT treatment. This study aims to examine characteristics of patients treated as outpatients without an ED visit to better understand differentiators between patients sent to the ED and those managed by outpatient providers.

METHODS: An EPIC report was generated for patients with an outpatient ultrasound for uncomplicated DVT between 03/01/2020 – 02/28/2021. Patients were excluded if they had a pulmonary embolism or an ED visit within 3 days of ultrasound. Study variables, obtained from electronic health records, included: age, gender, referring provider specialty, previous anticoagulant use, patient-provider relationship length, and social determinants of health (SDH). Variables were analyzed using descriptive statistics.

RESULTS: Of 205 patients with an ultrasound result, 44 patients were treated outpatient and did not visit an ED within 3 days of result. The average patient age was 59 years, with 55% being female. Most ultrasound referrals (n=30, 67%) were issued by a primary care physician (PCP). At the time of ultrasound, 12 (27%) patients were already on anticoagulation. The remaining 32 (73%) patients were initiated on anticoagulation shortly after the ultrasound. Patient-provider relationship had a median length of 472 days prior to referral for ultrasound. No patients appeared to experience medication access or SDH issues.

CONCLUSIONS: Outpatient interventions were typically managed via PCP and all patients were either on anticoagulation at time of ultrasound or received anticoagulants after ultrasound. PCPs treating outpatient DVT may account for access issues in determining treatment setting (outpatient vs. ED). Additional studies are necessary to determine decision making factors surrounding treatment setting of DVT.