PMID- 24644116
OWN - NLM
STAT- MEDLINE
DCOM- 20141217
LR  - 20190101
IS  - 1535-2900 (Electronic)
IS  - 1079-2082 (Linking)
VI  - 71
IP  - 7
DP  - 2014 Apr 1
TI  - Comparison of injectable anticoagulants for thromboprophylaxis after 
      cancer-related surgery.
PG  - 562-9
LID - 10.2146/ajhp120711 [doi]
AB  - PURPOSE: The clinical and economic outcomes associated with using injectable 
      anticoagulants for thromboprophylaxis after cancer-related surgery are evaluated. 
      METHODS: This retrospective cohort analysis was conducted from an institutional 
      perspective using hospital administrative data and examined patients age 18 years 
      or older who received unfractionated heparin (UFH), enoxaparin, dalteparin, or 
      fondaparinux after undergoing cancer-related surgery. Outcomes assessed included 
      venous thromboembolism (VTE) and major bleeding (MB) rates; VTE-related, 
      MB-related, and all-cause readmission rates; mean length of stay (LOS); and mean 
      total cost of care during hospitalization. RESULTS: In the 4068 patients 
      evaluated (1017 per group), VTE rates were similar for fondaparinux compared with 
      the other anticoagulants. The risk of MB was 80% higher for enoxaparin (p = 
      0.035) and 2.5 times higher for UFH (p = 0.0004) but not significantly higher for 
      dalteparin compared with fondaparinux. The mean LOS was 8% longer for patients 
      taking enoxaparin (p = 0.03) and dalteparin (p = 0.0494) and 21% longer for those 
      treated with UFH (p < 0.0001) compared with fondaparinux. The unadjusted mean +/- 
      S.D. total cost of care per patient was lower in the fondaparinux group compared 
      with the enoxaparin and UFH groups but higher compared with dalteparin. 
      CONCLUSION: A retrospective evaluation of hospital administrative data for 
      patients who had received thromboprophylaxis after cancer-related surgery 
      revealed a similar risk of VTE with fondaparinux compared with other injectable 
      anticoagulants. Fondaparinux was associated with a lower risk of MB compared with 
      enoxaparin and UFH but did not differ significantly from dalteparin in this 
      regard. A shorter LOS was observed for patients who received fondaparinux 
      compared with dalteparin, enoxaparin, and UFH. The total cost of care for 
      patients who received fondaparinux was lower compared with enoxaparin or UFH but 
      higher compared with dalteparin.
FAU - Changolkar, Arun
AU  - Changolkar A
AD  - Arun Changolkar, Ph.D., M.B.A., is President and Chief Executive Officer, SOAL 
      Pharmatech Solutions, Inc., Philadelphia, PA; at the time of this study he was 
      Manager, U.S. Health Outcomes, GlaxoSmithKline, Philadelphia. Laura Menditto, 
      M.B.A., M.P.H., is Owner, Laura A. Menditto LLC, Newtown, PA; at the time of this 
      study she was Director, Cardiovascular, Metabolic, and Oncology U.S. Health 
      Outcomes, GlaxoSmithKline. Manan Shah, Pharm.D., Ph.D., is Director, Health 
      Services and Outcomes Research, U.S. Medical, Bristol-Myers Squibb Company, 
      Tampa, FL; at the time of this study he was Director, Health Economics and 
      Outcomes Research, Xcenda, AmerisourceBergen Consulting Services, Palm Harbor, 
      FL. Katarzyna Puto, Pharm.D., M.B.A., BCOP, BCPS, s Associate Director, Global 
      Health Economics and Outcomes Research, Xcenda; at the time of this study she was 
      Assistant Director, Medical Communications, Xcenda. Eileen Farrelly, M.P.H., is 
      Associate Director, Xcenda.
FAU - Menditto, Laura
AU  - Menditto L
FAU - Shah, Manan
AU  - Shah M
FAU - Puto, Katarzyna
AU  - Puto K
FAU - Farrelly, Eileen
AU  - Farrelly E
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Cohort Studies
MH  - Enoxaparin/therapeutic use
MH  - Female
MH  - Health Care Costs
MH  - Heparin/therapeutic use
MH  - Humans
MH  - Injections
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*surgery
MH  - Postoperative Complications/*prevention & control
MH  - Retrospective Studies
MH  - Venous Thromboembolism/*prevention & control
EDAT- 2014/03/20 06:00
MHDA- 2014/12/18 06:00
CRDT- 2014/03/20 06:00
PHST- 2014/03/20 06:00 [entrez]
PHST- 2014/03/20 06:00 [pubmed]
PHST- 2014/12/18 06:00 [medline]
AID - 71/7/562 [pii]
AID - 10.2146/ajhp120711 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2014 Apr 1;71(7):562-9. doi: 10.2146/ajhp120711.