PMID- 35521006
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230202
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 57
IP  - 1
DP  - 2022 Feb
TI  - A Real-World Comparative Effectiveness Analysis of Thromboprophylactic Use of 
      Enoxaparin Versus Unfractionated Heparin in Abdominal Surgery Patients in a Large 
      U.S. Hospital Database.
PG  - 121-129
LID - 10.1177/0018578720987141 [doi]
AB  - Introduction: Little is known about outcomes associated with enoxaparin versus 
      unfractionated heparin (UFH) for venous thromboembolism (VTE) prophylaxis in 
      abdominal surgery patients in U.S. clinical practice. The purpose of this study 
      was to compare VTE, all-cause mortality, PE-related in-hospital mortality, and 
      hospital costs during abdominal surgery hospitalization and the 90 days 
      post-discharge between patients who received enoxaparin versus UFH prophylaxis. 
      Materials and Methods: Using the Premier Healthcare Database, abdominal surgery 
      patients who received at least 1 day of VTE prophylaxis with enoxaparin or UFH 
      were identified between January 1, 2010 and September 30, 2016. Clinical outcomes 
      were assessed using multivariable logistic regression models and cost outcomes 
      were assessed using generalized linear models. Results: Of 363,669 patients 
      identified, 59% received enoxaparin and 41% UFH. In adjusted analyses, there were 
      statistically significant lower odds of VTE (OR 0.80; 95% CI 0.65-0.97), 
      all-cause mortality (OR 0.67; 95% CI 0.60-0.75), and major bleeding (OR 0.88; 95% 
      CI 0.82-0.94) during the hospitalization for enoxaparin versus UFH, but no 
      differences during the 90-days post-discharge or for PE-related mortality. There 
      was a statistically significant lower total hospital cost with enoxaparin versus 
      UFH during index hospitalization ($8,913 vs $9,017, P < .0001), but not 
      post-discharge ($3,342 vs $3,368, P = .42). Unadjusted rates of heparin-induced 
      thrombocytopenia (index:0.1% vs 0.3%; post-discharge: 0.02% vs 0.06%) were 
      reported for enoxaparin and UFH, respectively. Conclusion: In contemporary U.S. 
      hospital practice, statistically significant lower odds of VTE, all-cause 
      mortality and major bleeding with enoxaparin versus UFH prophylaxis were found 
      during abdominal surgery hospitalizations.
CI  - (c) The Author(s) 2021.
FAU - Veeranki, S P
AU  - Veeranki SP
AD  - Premier Applied Sciences, Premier Inc., Charlotte, NC, USA.
AD  - University of Texas Medical Branch, Galveston, TX, USA.
AD  - Precision HEOR, Los Angeles, CA, USA.
FAU - Xiao, Z
AU  - Xiao Z
AD  - Sanofi, Cambridge, MA, USA.
FAU - Levorsen, A
AU  - Levorsen A
AUID- ORCID: 0000-0001-5038-029X
AD  - Sanofi, Oslo, Norway.
FAU - Sinha, M
AU  - Sinha M
AD  - Premier Applied Sciences, Premier Inc., Charlotte, NC, USA.
FAU - Shah, B
AU  - Shah B
AD  - Livongo Health, Mountain View, CA, USA.
AD  - Duke University, Durham, NC, USA.
LA  - eng
PT  - Journal Article
DEP - 20210119
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC9065531
OTO - NOTNLM
OT  - enoxaparin
OT  - general surgery
OT  - health care utilization
OT  - perioperative care
OT  - unfractionated heparin
OT  - venous thromboembolism
COIS- Declaration of Conflicting Interests: The author(s) declared the following 
      potential conflicts of interest with respect to the research, authorship, and/or 
      publication of this article: S. P. Veeranki was an employee of Premier Applied 
      Sciences during the conduct of the study. M. Sinha is an employee of Premier 
      Applied Sciences, Premier, Inc., which received funding from Sanofi US Services 
      Inc., the manufacturer of Lovenox (enoxaparin), for conducting this study. B. 
      Shah holds employment and equity from Livongo Health and also serves as a 
      consultant for Premier Inc., Janssen, and Medtronic. Z. Xiao was an employee of 
      Sanofi during the conduct of the study and A. Levorsen is an employee of Sanofi. 
      Both hold stock in Sanofi.
EDAT- 2022/05/07 06:00
MHDA- 2022/05/07 06:01
PMCR- 2023/02/01
CRDT- 2022/05/06 06:16
PHST- 2022/05/06 06:16 [entrez]
PHST- 2022/05/07 06:00 [pubmed]
PHST- 2022/05/07 06:01 [medline]
PHST- 2023/02/01 00:00 [pmc-release]
AID - 10.1177_0018578720987141 [pii]
AID - 10.1177/0018578720987141 [doi]
PST - ppublish
SO  - Hosp Pharm. 2022 Feb;57(1):121-129. doi: 10.1177/0018578720987141. Epub 2021 Jan 
      19.