PMID- 37029256
OWN - NLM
STAT- MEDLINE
DCOM- 20230501
LR  - 20230501
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 55
IP  - 4
DP  - 2023 May
TI  - Unfractionated heparin versus enoxaparin for venous thromboembolism prophylaxis 
      in intensive care units: a propensity score adjusted analysis.
PG  - 617-625
LID - 10.1007/s11239-023-02795-w [doi]
AB  - Venous thromboembolism (VTE) is a common complication in hospitalized patients. 
      Pharmacologic prophylaxis is used in order to reduce the risk of VTE events. The 
      main purpose of this study is to compare the prevalence of deep vein thrombosis 
      (DVT) and pulmonary embolism (PE) in patients admitted to the intensive care unit 
      (ICU) who received unfractionated heparin (UFH) versus enoxaparin as VTE 
      prophylaxis. Mortality was evaluated as a secondary outcome. This was a 
      Propensity Score Adjusted Analysis. Patients admitted to neurology, surgical, or 
      medical ICUs and screened with venous doppler ultrasonography or computed 
      tomography angiography for detection of VTE were included in the analysis. We 
      identified 2228 patients in the cohort, 1836 (82.4%) patients received UFH and 
      392 (17.6%) patients received enoxaparin. Propensity score matching yielded a 
      well-balanced cohort of 950 (74% UFH, 26% enoxaparin) patients. After matching, 
      there was no difference in prevalence of DVT (RR 1.05; 95% CI 0.67-1.64, 
      p = 0.85) and PE (RR 0.76; 95% CI, 0.44-1.30, p = 0.31). No significant 
      differences in location and severity of DVT and PE between the two groups were 
      detected. Hospital and intensive care unit stay was similar between the two 
      groups. Unfractionated heparin was associated with a higher rate of mortality, 
      (HR 2.04; 95% CI, 1.13-3.70; p = 0.019). The use of UFH as VTE prophylaxis in ICU 
      patients was associated with a similar prevalence of DVT and PE compared with 
      enoxaparin, and the site and degree of occlusion were similar. However, a higher 
      mortality rate was seen in the UFH group.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Samuel, Sophie
AU  - Samuel S
AUID- ORCID: 0000-0003-2544-900X
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, 6411 Fannin 
      Street, Houston, TX, 77030, USA. Sophie.Samuel@memorialhermann.org.
FAU - Li, Wen
AU  - Li W
AD  - Department of Internal Medicine, The University of Texas McGovern Medical School 
      at Houston, Houston, USA.
FAU - Dunn, Koren
AU  - Dunn K
AD  - College of Pharmacy, Texas A&M University, College Station, USA.
FAU - Cortes, Jennifer
AU  - Cortes J
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, 6411 Fannin 
      Street, Houston, TX, 77030, USA.
FAU - Nguyen, Thuy
AU  - Nguyen T
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, 6411 Fannin 
      Street, Houston, TX, 77030, USA.
FAU - Moussa, Daniel
AU  - Moussa D
AD  - College of Pharmacy, Univerity of Houston, Houston, USA.
FAU - Kumar, Abhay
AU  - Kumar A
AD  - Department of Neurosurgery, The University of Texas McGovern Medical School at 
      Houston, Houston, USA.
FAU - Dao, Thanh
AU  - Dao T
AD  - Department of Comparative Analytics, Memorial Hermann-Texas Medical Center, 
      Houston, USA.
FAU - Beeson, James
AU  - Beeson J
AD  - Department of Diagnostic Ultrasound, Memorial Hermann-Texas Medical Center, 
      Houston, USA.
FAU - Choi, H Alex
AU  - Choi HA
AD  - Department of Neurosurgery, The University of Texas McGovern Medical School at 
      Houston, Houston, USA.
FAU - McCullough, Louise D
AU  - McCullough LD
AD  - Department of Neurology, Memorial Hermann-Texas Medical Center, Houston, USA.
LA  - eng
PT  - Journal Article
DEP - 20230408
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 9005-49-6 (Heparin)
RN  - 0 (Enoxaparin)
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Humans
MH  - Heparin/adverse effects
MH  - Enoxaparin/adverse effects
MH  - *Venous Thromboembolism/epidemiology/etiology/prevention & control
MH  - Propensity Score
MH  - Anticoagulants/adverse effects
MH  - *Pulmonary Embolism/drug therapy
MH  - Intensive Care Units
MH  - Heparin, Low-Molecular-Weight/therapeutic use
OTO - NOTNLM
OT  - Deep vein thrombosis
OT  - Enoxaparin
OT  - Heparin
OT  - Pulmonary embolism
OT  - Venous thromboembolism
EDAT- 2023/04/08 06:00
MHDA- 2023/05/01 06:42
CRDT- 2023/04/07 23:24
PHST- 2023/03/10 00:00 [accepted]
PHST- 2023/05/01 06:42 [medline]
PHST- 2023/04/08 06:00 [pubmed]
PHST- 2023/04/07 23:24 [entrez]
AID - 10.1007/s11239-023-02795-w [pii]
AID - 10.1007/s11239-023-02795-w [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2023 May;55(4):617-625. doi: 10.1007/s11239-023-02795-w. 
      Epub 2023 Apr 8.