Safety of Single Preoperative Dose of Enoxaparin for Hepatectomy: A Study in a Country With Low Venous Thromboembolism Incidence.

IF 1.5 4区 医学 Q3 SURGERY
Thakerng Pitakteerabundit, Utcharee Intusoma, Nan-Ak Wiboonkhwan, Tortrakoon Thongkan
{"title":"Safety of Single Preoperative Dose of Enoxaparin for Hepatectomy: A Study in a Country With Low Venous Thromboembolism Incidence.","authors":"Thakerng Pitakteerabundit, Utcharee Intusoma, Nan-Ak Wiboonkhwan, Tortrakoon Thongkan","doi":"10.1111/ans.70168","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Postoperative venous thromboembolism (VTE) prophylaxis for hepatectomy is debated in low-VTE incidence regions like Thailand due to bleeding risks. This study evaluated single-dose preoperative enoxaparin safety for VTE prophylaxis, focusing on post-hepatectomy hemorrhage (PHH).</p><p><strong>Methods: </strong>This retrospective review compared VTE and PHH incidence before (no prophylaxis) and after implementation of a single preoperative dose of enoxaparin 40 mg for all patients undergoing elective hepatectomy in a center in Thailand. PHH and post-hepatectomy liver failure (PHLF) were defined per International Study Group of Liver Surgery criteria. Factors associated with PHH were analyzed using logistic regression.</p><p><strong>Results: </strong>One hundred eighty-six patients underwent elective hepatectomy (mean age 58 years). Fifty-two percent underwent major hepatectomy. PHLF occurred in 11% of patients. VTE occurred in 0% (0/96) of the pre-protocol and 1.1% (1/90) of the post-protocol group. PHH rate was 3.8%, with no difference between pre-protocol (3/96) and post-protocol groups (4/90). Factors associated with PHH were intraoperative transfusion > 2 units (OR 33.3; 95% CI 1.9-587.7) and PHLF (OR 17.2; 95% CI 2.1-140.8), but not enoxaparin (OR 1.9; 95% CI 0.3-12.8).</p><p><strong>Conclusions: </strong>Single preoperative enoxaparin did not increase PHH risk in this low VTE incidence cohort and may be considered for VTE prophylaxis in similar populations.</p>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ANZ Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ans.70168","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Postoperative venous thromboembolism (VTE) prophylaxis for hepatectomy is debated in low-VTE incidence regions like Thailand due to bleeding risks. This study evaluated single-dose preoperative enoxaparin safety for VTE prophylaxis, focusing on post-hepatectomy hemorrhage (PHH).

Methods: This retrospective review compared VTE and PHH incidence before (no prophylaxis) and after implementation of a single preoperative dose of enoxaparin 40 mg for all patients undergoing elective hepatectomy in a center in Thailand. PHH and post-hepatectomy liver failure (PHLF) were defined per International Study Group of Liver Surgery criteria. Factors associated with PHH were analyzed using logistic regression.

Results: One hundred eighty-six patients underwent elective hepatectomy (mean age 58 years). Fifty-two percent underwent major hepatectomy. PHLF occurred in 11% of patients. VTE occurred in 0% (0/96) of the pre-protocol and 1.1% (1/90) of the post-protocol group. PHH rate was 3.8%, with no difference between pre-protocol (3/96) and post-protocol groups (4/90). Factors associated with PHH were intraoperative transfusion > 2 units (OR 33.3; 95% CI 1.9-587.7) and PHLF (OR 17.2; 95% CI 2.1-140.8), but not enoxaparin (OR 1.9; 95% CI 0.3-12.8).

Conclusions: Single preoperative enoxaparin did not increase PHH risk in this low VTE incidence cohort and may be considered for VTE prophylaxis in similar populations.

肝切除术术前单剂量依诺肝素的安全性:一个静脉血栓栓塞发生率低的国家的研究。
背景:在泰国等低静脉血栓栓塞发生率地区,由于出血风险,肝切除术后静脉血栓栓塞(VTE)预防存在争议。本研究评估了术前单剂量依诺肝素预防静脉血栓栓塞的安全性,重点是肝切除术后出血(PHH)。方法:本回顾性研究比较了泰国某中心所有接受择期肝切除术的患者术前(无预防)和术前单剂量40mg依诺肝素后静脉血栓栓塞和PHH的发生率。PHH和肝切除术后肝衰竭(PHLF)是根据国际肝脏外科研究组的标准定义的。采用logistic回归分析与PHH相关的因素。结果:186例患者行择期肝切除术(平均年龄58岁)。52%的患者接受了肝切除术。11%的患者发生了PHLF。方案前组VTE发生率为0%(0/96),方案后组为1.1%(1/90)。PHH率为3.8%,方案前组(3/96)与方案后组(4/90)无差异。与PHH相关的因素是术中输血bb0.2单位(OR 33.3;95% CI 1.9-587.7)和PHLF (OR 17.2;95% CI 2.1-140.8),但依诺肝素没有(OR 1.9;95% ci 0.3-12.8)。结论:术前单独使用依诺肝素不会增加静脉血栓栓塞发生率低的队列患者的PHH风险,在类似人群中可考虑用于静脉血栓栓塞预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
ANZ Journal of Surgery
ANZ Journal of Surgery 医学-外科
CiteScore
2.50
自引率
11.80%
发文量
720
审稿时长
2 months
期刊介绍: ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信