Enoxaparin Venous Thromboembolism Prophylaxis Dosing in Critically Ill Underweight Patients.

IF 0.8 Q4 PHARMACOLOGY & PHARMACY
Elizabeth Curcio, Alyssa S Meester, Angela Harding, Marie M Lockhart, John Dillis
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Abstract

Purpose: Optimal dosing of VTE prophylaxis for specific patient populations remains an area of concern as insufficient evidence exists regarding dosing for underweight patients. The purpose of this study is to compare the incidence of major bleeding events in underweight patients given different prophylactic doses of enoxaparin. Methods: This is a retrospective analysis performed at multiple hospitals within a single health care system. Patients with a BMI < 18.5 kg/m2 were divided into 2 groups depending on whether they received at least 1 prophylactic dose of enoxaparin 30 mg subcutaneously once daily or enoxaparin 40 mg subcutaneously once daily. Underweight adult patients were included if they were admitted to an ICU for at least 48 hours and received at least 1 dose of enoxaparin for VTE prophylaxis during their ICU admission. The primary aim was to compare the incidence of clinically significant bleeding between dosing strategies. Secondary aims included the incidence of VTE during admission, ICU length of stay, overall hospital length of stay, and all-cause mortality 30 days post-discharge. Results: A total of 310 patients met inclusion criteria for this study, with 80 patients in the 30 mg group and 230 patients in the 40 mg group. There was no significant difference in major bleeding events between the 2 groups (P = .61). No significant differences in incidence of VTE (P = .455 ), ICU length of stay (P = .466), overall hospital stay (P = .502), or all-cause mortality (P = .925) were found between groups. Conclusions: No difference was found in clinically significant bleeding between underweight critically ill patients receiving VTE prophylaxis with enoxaparin 30 mg once daily or 40 mg once daily. Further studies are needed to evaluate the optimal dosing of VTE prophylaxis with enoxaparin in underweight patients.

依诺肝素预防危重体重过轻患者静脉血栓栓塞的剂量。
目的:针对特定患者群体的静脉血栓栓塞预防的最佳剂量仍然是一个值得关注的领域,因为关于体重过轻患者的剂量证据不足。本研究的目的是比较给予不同预防剂量依诺肝素的体重过轻患者大出血事件的发生率。方法:这是一项在单一医疗保健系统内的多家医院进行的回顾性分析。BMI为2的患者根据是否接受至少1次预防性剂量的依诺肝素30 mg每日皮下注射或依诺肝素40 mg每日皮下注射分为2组。体重过轻的成年患者如果在ICU住院至少48小时,并且在ICU住院期间接受了至少1剂量的依诺肝素用于静脉血栓栓塞预防,则纳入研究。主要目的是比较不同给药策略的临床显著出血发生率。次要目的包括入院时静脉血栓栓塞的发生率、ICU住院时间、总住院时间和出院后30天的全因死亡率。结果:共有310例患者符合本研究的纳入标准,其中30 mg组80例,40 mg组230例。两组间大出血事件发生率无显著差异(P = 0.61)。静脉血栓栓塞发生率无显著性差异(P =。455)、ICU住院时间(P = .466)、总住院时间(P = .502)或全因死亡率(P = .925)。结论:体重过轻的危重患者在静脉血栓栓塞预防中应用依诺肝素30mg / d与40mg / d无显著性出血差异。需要进一步的研究来评估用依诺肝素预防体重过轻患者静脉血栓栓塞的最佳剂量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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