PMID- 37208855
OWN - NLM
STAT- MEDLINE
DCOM- 20240108
LR  - 20240108
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 89
IP  - 12
DP  - 2023 Dec
TI  - Low Molecular Weight Heparin Is Superior for Venous Thromboembolism Prophylaxis 
      in High-Risk Geriatric Patients.
PG  - 5837-5841
LID - 10.1177/00031348231177922 [doi]
AB  - INTRODUCTION: Venous thromboembolism (VTE) is a source of preventable morbidity 
      and mortality in critically ill trauma patients. Age is one independent risk 
      factor. Geriatric patients embody a population at high thromboembolic and 
      hemorrhagic risk. Currently, there is little guidance between low molecular 
      weight heparin (LMWH) and unfractionated heparin (UFH) for anticoagulant 
      prophylaxis in the geriatric trauma patient. METHODS: A retrospective review was 
      conducted at an ACS verified, Level I Trauma center from 2014 to 2018. All 
      patients 65 years or older, with high-risk injuries and admitted to the trauma 
      service were included. Choice of agent was at provider discretion. Patients in 
      renal failure, or those that received no chemoprophylaxis, were excluded. The 
      primary outcomes were the diagnosis of deep vein thrombosis or pulmonary embolism 
      and bleeding associated complications (gastrointestinal bleed, TBI expansion, 
      hematoma development). RESULTS: This study evaluated 375 subjects, 245 (65%) 
      received enoxaparin and 130 (35%) received heparin. DVT developed in 6.9% of UFH 
      patients, compared to 3.3% with LMWH (P = .1). PE was present in 3.8% of UFH 
      group, but only .4% in the LMWH group (P = .01). Combined rate of DVT/PE was 
      significantly lower (P = .006) with LMWH (3.7%) compared to UFH (10.8%). 10 
      patients had documented bleeding events, and there was no significant association 
      between bleeding and the use of LMWH or UFH. CONCLUSIONS: VTE events are more 
      common in geriatric patients treated with UFH compared to LMWH. There was no 
      associated increase in bleeding complications when LMWH was utilized. LMWH should 
      be considered the chemoprophylatic agent of choice in high risk geriatric trauma 
      patients.
FAU - Deusenberry, Christina M
AU  - Deusenberry CM
AD  - School of Pharmacy, West Virginia University, Morgantown, WV, USA. RINGGOLD: 5631
FAU - Bardsley, Casey
AU  - Bardsley C
AD  - School of Pharmacy, West Virginia University, Morgantown, WV, USA. RINGGOLD: 5631
FAU - Sharon, Mindy
AU  - Sharon M
AD  - Department of Surgery, West Virginia University, Morgantown, WV, USA. RINGGOLD: 
      5631
FAU - Hobbs, Gerald R
AU  - Hobbs GR
AD  - Department of Statistic, West Virginia University, Morgantown, WV, USA. RINGGOLD: 
      5631
FAU - Wilson, Alison M
AU  - Wilson AM
AD  - Department of Surgery, West Virginia University, Morgantown, WV, USA. RINGGOLD: 
      5631
FAU - Bardes, James M
AU  - Bardes JM
AD  - Department of Surgery, West Virginia University, Morgantown, WV, USA. RINGGOLD: 
      5631
LA  - eng
PT  - Journal Article
DEP - 20230519
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
SB  - IM
MH  - Humans
MH  - Aged
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Heparin/therapeutic use
MH  - *Venous Thromboembolism/etiology/prevention & control/epidemiology
MH  - Anticoagulants/adverse effects
MH  - Enoxaparin/therapeutic use
MH  - *Pulmonary Embolism/prevention & control/complications
OTO - NOTNLM
OT  - pharmacy
OT  - trauma
COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/05/20 09:42
MHDA- 2024/01/08 06:42
CRDT- 2023/05/20 01:03
PHST- 2024/01/08 06:42 [medline]
PHST- 2023/05/20 09:42 [pubmed]
PHST- 2023/05/20 01:03 [entrez]
AID - 10.1177/00031348231177922 [doi]
PST - ppublish
SO  - Am Surg. 2023 Dec;89(12):5837-5841. doi: 10.1177/00031348231177922. Epub 2023 May 
      19.