PMID- 33246191
OWN - NLM
STAT- MEDLINE
DCOM- 20210617
LR  - 20210617
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 198
DP  - 2021 Feb
TI  - Weight-adjusted tinzaparin for venous thromboembolism prophylaxis in bariatric 
      surgery patients weighing 160 kg or more.
PG  - 1-6
LID - S0049-3848(20)30628-9 [pii]
LID - 10.1016/j.thromres.2020.11.021 [doi]
AB  - INTRODUCTION: Bariatric surgery patients experience an increased risk of venous 
      thromboembolism (VTE), however, the optimal dose of low-molecular-weight heparin 
      for VTE prophylaxis remains uncertain. Currently, St. Joseph's Healthcare 
      Hamilton utilizes a weight-adjusted tinzaparin dosage (50 to 75 units/kg rounded 
      to nearest pre-filled syringe) for postoperative VTE prophylaxis. OBJECTIVES: 
      This study analyzed the safety of weight-adjusted tinzaparin for VTE prophylaxis 
      in bariatric surgery patients weighing >/=160 kg. METHODS: This was a retrospective 
      study involving patients weighing >/=160 kg that underwent bariatric surgery from 
      September 2015 to September 2019. Patients received a single dose of 
      weight-adjusted subcutaneous unfractionated heparin (UFH) [5000 or 7500 IU] 
      immediately prior to surgery, subcutaneous UFH [5000 IU, 7500 IU, or unspecified] 
      immediately postoperatively, and either 10,000 or 14,000 IU of tinzaparin, 
      beginning on the day after surgery, for 10 days. Intra-operative sequential 
      compression devices could be used at the attending surgeon's discretion. 
      Occurrence of VTE and major bleeding within 30 days of surgery were assessed. 
      RESULTS: A total of 389 patients were included for analysis, all patients 
      received in-hospital follow-up while 349 patients had also 30-day follow-up. For 
      the primary safety and efficacy analysis of in-hospital events, VTE and major 
      bleeding rates were 0.26% [95% CI 0.01%-1.44%] (1/389) and 0.77% [95% CI 
      0.21%-2.24%] (3/389) respectively. For patients with 30-day follow-up VTE and 
      major bleeding rates were 0.57% [95% CI 0.1%-2.07%] (2/349) and 1.43% [95% CI 
      0.61%-3.3%] (5/349) respectively. CONCLUSIONS: Weight-adjusted tinzaparin was 
      associated with a low risk of bleeding and VTE events, supporting its use for VTE 
      prophylaxis for patients weighing >/=160 kg.
CI  - Copyright (c) 2020. Published by Elsevier Ltd.
FAU - Li, A
AU  - Li A
AD  - University of Ottawa, Faculty of Medicine, Ottawa, Canada. Electronic address: 
      Allen.li@uottawa.ca.
FAU - Eshaghpour, A
AU  - Eshaghpour A
AD  - McMaster University, Michael G. DeGroote School of Medicine, Hamilton, Canada.
FAU - Tseng, E K
AU  - Tseng EK
AD  - St. Michael's Hospital, Division of Hematology/Oncology, Toronto, Canada; 
      University of Toronto, Department of Medicine, Toronto, Canada.
FAU - Douketis, J D
AU  - Douketis JD
AD  - McMaster University, Department of Medicine, Hamilton, Canada.
FAU - Anvari, M
AU  - Anvari M
AD  - McMaster University, Department of Surgery, Hamilton, Canada.
FAU - Tiboni, M
AU  - Tiboni M
AD  - McMaster University, Department of Medicine, Hamilton, Canada.
FAU - Siegal, D M
AU  - Siegal DM
AD  - University of Ottawa, Department of Medicine, Ottawa, Canada; The Ottawa Hospital 
      Research Institute, Ottawa, Canada.
FAU - Ikesaka, R T
AU  - Ikesaka RT
AD  - McMaster University, Department of Medicine, Hamilton, Canada; St.Joseph's 
      Healthcare Hamilton, Hamilton, Division of Hematology, Hamilton, Canada.
FAU - Crowther, M A
AU  - Crowther MA
AD  - McMaster University, Department of Medicine, Hamilton, Canada; St.Joseph's 
      Healthcare Hamilton, Hamilton, Division of Hematology, Hamilton, Canada.
LA  - eng
PT  - Journal Article
DEP - 20201122
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 7UQ7X4Y489 (Tinzaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - *Bariatric Surgery/adverse effects
MH  - Heparin
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Retrospective Studies
MH  - Tinzaparin
MH  - *Venous Thromboembolism/etiology/prevention & control
EDAT- 2020/11/28 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/11/27 20:10
PHST- 2020/08/04 00:00 [received]
PHST- 2020/10/31 00:00 [revised]
PHST- 2020/11/19 00:00 [accepted]
PHST- 2020/11/28 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/11/27 20:10 [entrez]
AID - S0049-3848(20)30628-9 [pii]
AID - 10.1016/j.thromres.2020.11.021 [doi]
PST - ppublish
SO  - Thromb Res. 2021 Feb;198:1-6. doi: 10.1016/j.thromres.2020.11.021. Epub 2020 Nov 
      22.