PMID- 19652883
OWN - NLM
STAT- MEDLINE
DCOM- 20091021
LR  - 20220321
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 102
IP  - 2
DP  - 2009 Aug
TI  - Clinical and economic outcomes in patients at risk of venous thromboembolism 
      receiving appropriate enoxaparin or unfractionated heparin prophylaxis.
PG  - 321-6
LID - 10.1160/TH09-03-0147 [doi]
AB  - Clinical and economic outcomes were compared following appropriate prophylaxis 
      with enoxaparin or unfractionated heparin (UFH) in a large, real-world population 
      of US hospitalised medical and surgical patients at risk of venous 
      thromboembolism (VTE). Discharges from the Thomson Reuters MarketScan Hospital 
      Drug Database (January 2004-March 2007) of patients aged > or =40 years, at risk 
      of VTE according to the 7(th) American College of Chest Physicians (ACCP) 
      guidelines, who spent > or =6 days in hospital and received appropriate 
      ACCP-recommended enoxaparin or UFH prophylaxis were included. Patients with 
      contraindications to anticoagulation were excluded. Hospital-acquired VTE, 
      adverse events, and hospital costs for enoxaparin versus UFH were compared using 
      univariate and multivariate analyses. Of the 5,136 discharges included, 4,014 
      (78%) received enoxaparin and 1,122 (22%) received UFH. Compared with UFH, 
      enoxaparin was associated with significantly lower risk of hospital-acquired VTE 
      (adjusted odds ratio [OR] 0.51, 95% confidence interval [CI] 0.30-0.86, p = 
      0.012), pulmonary embolism (adjusted OR 0.33, 95% CI 0.14-0.79, p = 0.013) or 
      adverse events (adjusted OR 0.73, 95% CI 0.54-0.98, p = 0.034). Total hospital 
      costs per discharge were lower for enoxaparin (US $16,865 +/- 10,979) than UFH 
      (US $19,252 +/- 14,970), with a mean difference of US $2,388 in favour of 
      enoxaparin (p < 0.001) (adjusted difference US $439, 95% CI US $ -39 to 909, p = 
      0.072). In patients at risk of VTE, appropriate enoxaparin prophylaxis was 
      associated with a reduction in hospital-acquired VTE, adverse events, and costs 
      compared with appropriate UFH prophylaxis. Increased appropriate use of 
      enoxaparin in patients at risk of VTE may help to reduce the clinical and 
      economic burden of this condition.
FAU - Amin, Alpesh N
AU  - Amin AN
AD  - University of California - Irvine, Orange, CA 92868, USA. anamin@uci.edu
FAU - Lin, Jay
AU  - Lin J
FAU - Lenhart, Greg
AU  - Lenhart G
FAU - Schulman, Kathy L
AU  - Schulman KL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/adverse effects/*economics/*pharmacology
MH  - Enoxaparin/adverse effects/*economics/*pharmacology
MH  - Female
MH  - Heparin/adverse effects/*economics/*pharmacology
MH  - Hospital Costs
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Treatment Outcome
MH  - United States
MH  - Venous Thromboembolism/*economics/*prevention & control
EDAT- 2009/08/05 09:00
MHDA- 2009/10/22 06:00
CRDT- 2009/08/05 09:00
PHST- 2009/08/05 09:00 [entrez]
PHST- 2009/08/05 09:00 [pubmed]
PHST- 2009/10/22 06:00 [medline]
AID - TH09-03-0147 [pii]
AID - 10.1160/TH09-03-0147 [doi]
PST - ppublish
SO  - Thromb Haemost. 2009 Aug;102(2):321-6. doi: 10.1160/TH09-03-0147.