PMID- 31564199
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20220422
IS  - 1531-1937 (Electronic)
IS  - 0897-1900 (Linking)
VI  - 34
IP  - 3
DP  - 2021 Jun
TI  - Evaluation of Time to Therapeutic Anticoagulation and Associated Outcomes in 
      Critically Ill, Obese Patients With Pulmonary Embolism Receiving Unfractionated 
      Heparin.
PG  - 438-444
LID - 10.1177/0897190019878073 [doi]
AB  - BACKGROUND: Delays in time to therapeutic activated partial thromboplastin time 
      (aPTT) have been associated with poor outcomes in patients with acute pulmonary 
      embolism (PE). OBJECTIVE: To investigate the relationship between time to 
      therapeutic anticoagulation and in-hospital mortality in critically ill, obese 
      patients with acute PE. METHODS: This study examined 204 critically ill patients 
      with a body mass index (BMI) >/=30 kg/m(2) receiving unfractionated heparin (UFH) 
      for PE treatment. Patients achieving therapeutic anticoagulation within 24 hours 
      of UFH initiation (early) were compared to those in >24 hours (delayed). 
      Additional end points included 30-day mortality, median time to therapeutic aPTT, 
      proportion of therapeutic and supratherapeutic aPTT values, hemodynamic 
      deterioration, thrombolytic therapy after UFH initiation, length of stay, and 
      bleeding. RESULTS: No difference in in-hospital or 30-day all-cause mortality was 
      seen (odds ratio [OR]: 1.33, confidence interval [CI]: 0.647-2.72; OR: 1.003, CI: 
      0.514-1.96). Patients in the early group had a greater proportion of therapeutic 
      aPTT values (66.7% vs 50%, P < .001) and higher percentage of supratherapeutic 
      aPTT values (20.9% vs 11.3%, P < .001); however, no increase in clinically 
      significant bleeding was evident (15.2% vs 10.9%, P = .366). CONCLUSION: In this 
      population, a shorter time to therapeutic aPTT was not associated with improved 
      survival.
FAU - Sutton, Lauren H
AU  - Sutton LH
AUID- ORCID: 0000-0001-7394-369X
AD  - Department of Pharmacy, 21737Barnes-Jewish Hospital, Saint Louis, MO, USA.
FAU - Tellor, Bethany R
AU  - Tellor BR
AD  - Department of Pharmacy, 21737Barnes-Jewish Hospital, Saint Louis, MO, USA.
FAU - Pope, Hannah E
AU  - Pope HE
AD  - Department of Pharmacy, 21737Barnes-Jewish Hospital, Saint Louis, MO, USA.
FAU - Riney, Jennifer N
AU  - Riney JN
AD  - Department of Pharmacy, 21737Barnes-Jewish Hospital, Saint Louis, MO, USA.
FAU - Weaver, Katherine L
AU  - Weaver KL
AD  - Department of Pharmacy, 5170University of Louisville Hospital, Louisville, KY, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20190929
PL  - United States
TA  - J Pharm Pract
JT  - Journal of pharmacy practice
JID - 8900945
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants
MH  - Critical Illness
MH  - *Heparin
MH  - Humans
MH  - Obesity/complications/drug therapy
MH  - *Pulmonary Embolism/diagnosis/drug therapy
OTO - NOTNLM
OT  - mortality
OT  - obesity
OT  - pulmonary embolism
OT  - therapeutic anticoagulation
OT  - unfractionated heparin
EDAT- 2019/10/01 06:00
MHDA- 2021/05/15 06:00
CRDT- 2019/10/01 06:00
PHST- 2019/10/01 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2019/10/01 06:00 [entrez]
AID - 10.1177/0897190019878073 [doi]
PST - ppublish
SO  - J Pharm Pract. 2021 Jun;34(3):438-444. doi: 10.1177/0897190019878073. Epub 2019 
      Sep 29.