Unfractionated heparin versus enoxaparin for venous thromboembolism prophylaxis in intensive care units: a propensity score adjusted analysis

被引:2
|
作者
Samuel, Sophie [1 ]
Li, Wen [2 ]
Dunn, Koren [3 ]
Cortes, Jennifer [1 ]
Nguyen, Thuy [1 ]
Moussa, Daniel [4 ]
Kumar, Abhay [5 ]
Dao, Thanh [6 ]
Beeson, James [7 ]
Choi, H. Alex [5 ]
McCullough, Louise D. [8 ]
机构
[1] Mem Hermann Texas Med Ctr, Dept Pharm, 6411 Fannin St, Houston, TX 77030 USA
[2] Univ Texas Houston, McGovern Med Sch, Dept Internal Med, Houston, TX USA
[3] Texas A&M Univ, Coll Pharm, College Stn, TX USA
[4] Univ Houston, Coll Pharm, Houston, TX USA
[5] Univ Texas McGovern, Med Sch Houston, Dept Neurosurg, Houston, TX USA
[6] Mem Hermann Texas Med Ctr, Dept Comparat Analyt, Houston, TX USA
[7] Mem Hermann Texas Med Ctr, Dept Diagnost Ultrasound, Houston, TX USA
[8] Mem Hermann Texas Med Ctr, Dept Neurol, Houston, TX USA
关键词
Venous thromboembolism; Deep vein thrombosis; Pulmonary embolism; Heparin; Enoxaparin; PREVENTION; THROMBOPROPHYLAXIS; METAANALYSIS; THROMBOSIS; PATIENT; RISK;
D O I
10.1007/s11239-023-02795-w
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Venous thromboembolism (VTE) is a common complication in hospitalized patients. Pharmacologic prophylaxis is used in order to reduce the risk of VTE events. The main purpose of this study is to compare the prevalence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients admitted to the intensive care unit (ICU) who received unfractionated heparin (UFH) versus enoxaparin as VTE prophylaxis. Mortality was evaluated as a secondary outcome. This was a Propensity Score Adjusted Analysis. Patients admitted to neurology, surgical, or medical ICUs and screened with venous doppler ultrasonography or computed tomography angiography for detection of VTE were included in the analysis. We identified 2228 patients in the cohort, 1836 (82.4%) patients received UFH and 392 (17.6%) patients received enoxaparin. Propensity score matching yielded a well-balanced cohort of 950 (74% UFH, 26% enoxaparin) patients. After matching, there was no difference in prevalence of DVT (RR 1.05; 95% CI 0.67-1.64, p = 0.85) and PE (RR 0.76; 95% CI, 0.44-1.30, p = 0.31). No significant differences in location and severity of DVT and PE between the two groups were detected. Hospital and intensive care unit stay was similar between the two groups. Unfractionated heparin was associated with a higher rate of mortality, (HR 2.04; 95% CI, 1.13-3.70; p = 0.019). The use of UFH as VTE prophylaxis in ICU patients was associated with a similar prevalence of DVT and PE compared with enoxaparin, and the site and degree of occlusion were similar. However, a higher mortality rate was seen in the UFH group.
引用
收藏
页码:617 / 625
页数:9
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