PMID- 33215504
OWN - NLM
STAT- MEDLINE
DCOM- 20210906
LR  - 20210906
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 55
IP  - 8
DP  - 2021 Aug
TI  - Safety of High-Dose Unfractionated Heparin for Prophylaxis of Venous 
      Thromboembolism in Hospitalized Obese Patients.
PG  - 963-969
LID - 10.1177/1060028020974569 [doi]
AB  - BACKGROUND: Optimal dosing of unfractionated heparin (UFH) for thromboprophylaxis 
      in the obese patient population is uncertain because of their high-risk, 
      prothrombotic state and a complexity of pharmacokinetic considerations. 
      Literature on the appropriateness of the use of a higher dose UFH regimen remains 
      unclear and inconsistent. OBJECTIVE: To evaluate the safety of the use of 7500 
      units every 8 hours (high-dose) of subcutaneous UFH compared with the use of 5000 
      units every 8 hours (standard-dose) of subcutaneous UFH for thromboprophylaxis in 
      obese patients (defined as BMI >/=30 kg/m(2)). METHODS: In a retrospective cohort 
      study, 326 adult patients were included, with a BMI >/=30 kg/m(2), who were 
      admitted to a large, urban academic medical center between September 1, 2015, and 
      September 1, 2018. Patients received either high-dose or standard-dose UFH for at 
      least 48 hours. The primary end point was the incidence rate of bleeding events, 
      defined as a >/=2-g/dL fall in hemoglobin level or receipt of transfusion of 2 or 
      more units of packed red blood cells (pRBCs) from the start of the UFH order. 
      RESULTS: The incidence rate of bleeding was significantly higher in those who 
      received high-dose UFH (43%) compared with those who received standard-dose UFH 
      (29%; P = 0.008). No significant difference was found between venous 
      thromboembolism event rates. CONCLUSION AND RELEVANCE: High-dose UFH was 
      associated with an increased bleeding event rate compared with standard-dose UFH 
      in patients with a BMI >/=30 kg/m(2). This raises safety concerns about the 
      appropriateness of utilizing this regimen in this population.
FAU - Regis, Teresa
AU  - Regis T
AUID- ORCID: 0000-0003-3420-9139
AD  - Montefiore Medical Center, Bronx, NY, USA.
FAU - Goriacko, Pavel
AU  - Goriacko P
AUID- ORCID: 0000-0001-6875-3082
AD  - Montefiore Medical Center, Bronx, NY, USA.
AD  - Albert Einstein College of Medicine, Bronx, NY, USA.
FAU - Ferguson, Nadia
AU  - Ferguson N
AD  - Montefiore Medical Center, Bronx, NY, USA.
AD  - Albert Einstein College of Medicine, Bronx, NY, USA.
LA  - eng
PT  - Journal Article
DEP - 20201120
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/adverse effects
MH  - *Heparin/adverse effects
MH  - Heparin, Low-Molecular-Weight
MH  - Humans
MH  - Obesity/complications
MH  - Retrospective Studies
MH  - *Venous Thromboembolism/epidemiology/prevention & control
OTO - NOTNLM
OT  - bleeding
OT  - heparin
OT  - obesity
OT  - safety
OT  - thromboprophylaxis
OT  - venous thromboembolism
EDAT- 2020/11/21 06:00
MHDA- 2021/09/07 06:00
CRDT- 2020/11/20 08:39
PHST- 2020/11/21 06:00 [pubmed]
PHST- 2021/09/07 06:00 [medline]
PHST- 2020/11/20 08:39 [entrez]
AID - 10.1177/1060028020974569 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2021 Aug;55(8):963-969. doi: 10.1177/1060028020974569. Epub 
      2020 Nov 20.