keyword
https://read.qxmd.com/read/37335174/creatinine-clearance-predicts-the-goal-enoxaparin-dose-in-traumatic-brain-injury
#21
JOURNAL ARTICLE
Greigory Park, Navpreet K Dhillon, Nicole M Fierro, Peter Drevets, John Stupinski, Eric J Ley
BACKGROUND: Patients with traumatic brain injury (TBI) are at high risk of venous thromboembolism (VTE). Recent guidelines recommend starting TBI patients on enoxaparin 30 mg twice daily and then considering weight-based dosing. Creatinine clearance may be better than weight for patients when considering high and low enoxaparin dose requirements. We hypothesize that creatinine clearance (CrCl) predicts goal enoxaparin dose better than weight-based dosing. METHODS: A retrospective review was conducted on patients admitted to an urban, academic Level 1 trauma center from August 2017 to February 2020...
June 19, 2023: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/37329634/inadequate-venous-thromboembolism-chemoprophylaxis-is-associated-with-higher-venous-thromboembolism-rates-among-trauma-patients-with-epidurals
#22
JOURNAL ARTICLE
Navpreet K Dhillon, Tobias Muniz, Nicole M Fierro, Anaar E Siletz, Juliet Alexander, Chidinma Ikonte, Russell Mason, Eric J Ley
INTRODUCTION: Guidelines encourage higher doses of low molecular weight heparin (LMWH) for prophylaxis in trauma patients. The risks of LMWH must be considered for patients who require an epidural catheter. We compared adequate and inadequate prophylaxis to determine if venous thromboembolism (VTE) and complication rates differed among patients with epidural catheters. METHODS: Trauma patients who required an epidural catheter between 2012 and 2019 were reviewed for VTE and epidural-related complications...
June 15, 2023: Journal of Surgical Research
https://read.qxmd.com/read/37314427/early-venous-thromboembolism-prophylaxis-in-patients-with-trauma-intracranial-hemorrhage-analysis-of-the-prospective-multicenter-clott-study
#23
JOURNAL ARTICLE
Yu-Tung Wu, Chih-Ying Chien, Kazuhide Matsushima, Morgan Schellenberg, Kenji Inaba, Ernest E Moore, Angela Sauaia, M Margaret Knudson, Matthew J Martin
BACKGROUND: The optimal time to initiate venous thromboembolism prophylaxis (VTEp) for patients with intracranial hemorrhage (ICH) is controversial and must balance the risks of VTE with potential progression of ICH. We sought to evaluate the efficacy and safety of early VTEp initiation after traumatic ICH. METHODS: This is a secondary analysis of the prospective multicenter Consortium of Leaders in the Study of Thromboembolism (CLOTT) study. Patients with head AIS > 2 and with immediate VTEp held due to ICH were included...
June 12, 2023: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/37261550/hormone-replacement-therapy-does-not-increase-thrombosis-risk-following-tha-a-national-database-study
#24
JOURNAL ARTICLE
Brian P McCormick, Sean B Sequeira, Mark D Hasenauer, Henry R Boucher
PURPOSE: Hormone replacement therapy (HRT) causes a significant increase in the risk of venous thrombosis. The risk of medical and surgery-related complications among women taking HRT following total hip arthroplasty (THA) is poorly understood, and there are currently no guidelines in place regarding venous thromboembolism prophylaxis in this patient population. The purpose of this study was to evaluate the frequency of early medical and surgery-related complications following THA among women taking HRT...
June 1, 2023: Journal of Experimental Orthopaedics
https://read.qxmd.com/read/37208855/low-molecular-weight-heparin-is-superior-for-venous-thromboembolism-prophylaxis-in-high-risk-geriatric-patients
#25
JOURNAL ARTICLE
Christina M Deusenberry, Casey Bardsley, Mindy Sharon, Gerald R Hobbs, Alison M Wilson, James M Bardes
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...
May 19, 2023: American Surgeon
https://read.qxmd.com/read/37186173/outcomes-from-a-prospectively-implemented-protocol-using-apixaban-after-robot-assisted-radical-cystectomy
#26
JOURNAL ARTICLE
Jordan M Rich, Yuval Elkun, Jack Geduldig, Etienne Lavallee, Reza Mehrazin, Kyrollis Attalla, Peter Wiklund, John P Sfakianos
OBJECTIVES: To compare the safety and efficacy of oral apixaban with that of injectable enoxaparin after robot-assisted radical cystectomy (RARC) for venous thromboembolism (VTE) thromboprophylaxis. MATERIALS AND METHODS: We conducted a retrospective review of prospectively collected data for all RARC patients treated at our tertiary care centre between 2018 and 2022. The study included two groups: patients who were subject to a prospectively implemented protocol from October 2021 to the present, comprising a 21-day postoperative course of apixaban 2...
October 2023: BJU International
https://read.qxmd.com/read/37029256/unfractionated-heparin-versus-enoxaparin-for-venous-thromboembolism-prophylaxis-in-intensive-care-units-a-propensity-score-adjusted-analysis
#27
JOURNAL ARTICLE
Sophie Samuel, Wen Li, Koren Dunn, Jennifer Cortes, Thuy Nguyen, Daniel Moussa, Abhay Kumar, Thanh Dao, James Beeson, H Alex Choi, Louise D McCullough
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...
May 2023: Journal of Thrombosis and Thrombolysis
https://read.qxmd.com/read/36861137/safety-and-efficacy-of-extended-postdischarge-venous-thromboembolism-prophylaxis-in-microsurgical-breast-reconstruction
#28
JOURNAL ARTICLE
Marek A Hansdorfer, Rachel L Sadowsky, Sydney R Horen, Adan Z Becerra, Deana S Shenaq, George Kokosis
UNLABELLED: Discharging patients on extended postoperative venous thromboembolism (VTE) prophylaxis is trending in microsurgical breast reconstruction (MBR). This study investigated contemporary bleeding and thromboembolic complications after MBR and reported postdischarge enoxaparin outcomes. METHODS: The PearlDiver database was queried for MBR patients who did not receive postdischarge VTE prophylaxis (cohort 1) and MBR patients discharged with enoxaparin for at least 14 days (cohort 2), then queried for hematoma, deep venous thrombosis (DVT), and/or pulmonary embolism...
February 2023: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/36805121/safety-and-efficacy-of-rivaroxaban-in-primary-total-hip-and-knee-arthroplasty
#29
JOURNAL ARTICLE
Amit S Piple, Jennifer C Wang, Hyunwoo P Kang, Emily S Mills, Cory K Mayfield, Jay R Lieberman, Alexander B Christ, Nathanael D Heckmann
BACKGROUND: An optimal venous thromboembolism prophylaxis agent should balance efficacy and safety. While rivaroxaban provides effective venous thromboembolism prophylaxis after total joint arthroplasty, it may be associated with higher rates of bleeding. This study aimed to compare the safety and efficacy of rivaroxaban to aspirin and enoxaparin. METHODS: A large national database was queried for patients who underwent elective primary total hip (THA) or total knee arthroplasty (TKA) from January 2015 through December 2020 who received rivaroxaban, aspirin, or enoxaparin...
February 18, 2023: Journal of Arthroplasty
https://read.qxmd.com/read/36644743/effectiveness-and-safety-of-high-dose-thromboprophylaxis-in-morbidly-obese-major-trauma-patients
#30
JOURNAL ARTICLE
Emily Deremiah, Crystal Franco-Martinez, Conrado Gamboa, Kelly Sponhaltz, Lindsey Rippee, Kelly Reveles, Dana Foster
BACKGROUND: Trauma increases risk for venous thromboembolism (VTE) and obesity is a known independent risk factor for VTE development. Currently, no consensus on an optimal prophylactic dosing strategy for morbidly obese trauma patients exists. The objective of this study is to evaluate the effectiveness and safety of a BMI-stratified dosing strategy for VTE prophylaxis in morbidly obese trauma patients. METHODS: This was a single center, retrospective cohort study of adult major trauma patients with a body mass index (BMI) of ≥40 kg/m2 admitted to the surgical-trauma intensive care unit from April 2014 to July 2020...
February 2023: Hospital Pharmacy
https://read.qxmd.com/read/36624202/enoxaparin-may-be-associated-with-lower-rates-of-mortality-than-unfractionated-heparin-in-neurocritical-and-surgical-patients
#31
JOURNAL ARTICLE
Sophie Samuel, Catherine To, Yaobin Ling, Kai Zhang, Xiaoqian Jiang, Elmer V Bernstam
Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are often administered to prevent venous thromboembolism (VTE) in critically ill patients. However, the preferred prophylactic agent (UFH or LMWH) is not known. We compared the all-cause mortality rate in patients receiving UFH to LMWH for VTE prophylaxis. We conducted a retrospective propensity score adjusted analysis of patients admitted to neuro-critical, surgical, or medical intensive care units. Patients were included if they were screened with venous duplex ultrasonography or computed tomography angiography for detection of VTE...
April 2023: Journal of Thrombosis and Thrombolysis
https://read.qxmd.com/read/36413425/pharmacological-interventions-for-preventing-venous-thromboembolism-in-people-undergoing-bariatric-surgery
#32
REVIEW
Fabio Cf Amaral, Jose Cc Baptista-Silva, Luis Cu Nakano, Ronald Lg Flumignan
BACKGROUND: Venous thromboembolism (VTE), which comprises deep vein thrombosis (DVT) and pulmonary embolism (PE), is the leading cause of preventable death in hospitalised people and the third most common cause of mortality in surgical patients. People undergoing bariatric surgery have the additional risk factor of being overweight. Although VTE prophylaxis in surgical patients is well established, the best way to prevent VTE in those undergoing bariatric surgery is less clear. OBJECTIVES: To evaluate the benefits and harms of pharmacological interventions (alone or in combination) on venous thromboembolism and other health outcomes in people undergoing bariatric surgery compared to the same pharmacological intervention administered at a different dose or frequency, the same pharmacological intervention or started at a different time point, another pharmacological intervention, no intervention or placebo...
November 22, 2022: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/36380306/thromboprophylaxis-with-unilateral-pneumatic-device-led-to-less-edema-and-blood-loss-compared-to-enoxaparin-after-knee-arthroplasty-randomized-trial
#33
RANDOMIZED CONTROLLED TRIAL
João Alberto Ramos Maradei-Pereira, Marcel Lobato Sauma, Marco Kawamura Demange
BACKGROUND: Pharmacological and mechanical thromboprophylaxis are frequently used together after total knee arthroplasty (TKA). Most studies in this context compare anticoagulants versus a combination of these drugs with an intermittent pneumatic compression device (IPCD). However, there is uncertainty about the need for the combination of both and whether a unilateral IPCD would alone affect other important clinical outcomes: edema and blood loss. We compared the effects of enoxaparin versus unilateral portable IPCD after TKA on edema and blood loss...
November 15, 2022: BMC Musculoskeletal Disorders
https://read.qxmd.com/read/36337799/a-case-of-deep-vein-thrombosis-after-recovery-from-covid-19-and-its-association-with-elevated-d-dimers
#34
Naresh Dasari, Akshat Banga, Namratha Pallipamu, Trupti Pandit, Ramesh Pandit, Ramesh Adhikari
The coronavirus disease 2019 (COVID-19) continues to be a devastating disease for the elderly population, especially in long-term care facilities, and it presents with varying clinical presentations. We have ample evidence that COVID-19 can predispose to deep vein thrombosis (DVT) and pulmonary embolism (PE) during an active infection. Still, very few cases of DVT have been reported after recovery from COVID-19. The imbalance of the coagulation cascade and the increased release of certain coagulation factors play an essential role in promoting hypercoagulability and vascular endothelial dysfunction...
October 2022: Curēus
https://read.qxmd.com/read/36283281/low-molecular-weight-heparin-enoxaparin-versus-unfractionated-heparin-for-venous-thromboembolism-prophylaxis-in-patients-undergoing-craniotomy
#35
JOURNAL ARTICLE
Viswajit Kandula, Parth V Shah, Vineeth M Thirunavu, Ketan Yerneni, Constantine Karras, Zachary A Abecassis, Benjamin Hopkins, Orin Bloch, Matthew B Potts, Babak S Jahromi, Matthew C Tate
OBJECTIVE: To explore the difference in post-operative DVT, PE, and ICH complications following administration of prophylactic UFH or enoxaparin in patients undergoing craniotomy. METHODS: A retrospective chart review was conducted for 542 patients at our institution receiving either 5000units/0.5 mL UFH (BID or TID; 180 patients) or single daily 40 mg/0.4 mL enoxaparin (362 patients) following craniotomy. Multivariate linear regression models were developed comparing rates of postoperative DVT, PE, and reoperation for bleeding in patients given enoxaparin versus UFH prophylaxis while controlling for age at surgery, history of VTE, surgery duration, number of post-operative hospital days, reoperation, post-operative infections, and reason for surgery (tumor type, genetics, etc...
December 2022: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/36203245/venous-thromboembolism-risk-after-spinal-cord-injury-a-secondary-analysis-of-the-clott-study
#36
JOURNAL ARTICLE
Laura N Godat, Elliott R Haut, Ernest E Moore, M Margaret Knudson, Todd W Costantini
INTRODUCTION: Patients with spinal cord injury (SCI) are at high risk of venous thromboembolism (VTE). Pharmacologic VTE prophylaxis (VTEppx) is frequently delayed in patients with SCI because of concerns for bleeding risk. Here, we hypothesized that delaying VTEppx until >48 hours would be associated with increased risk of thrombotic events. METHODS: This is a secondary analysis of the 2018 to 2020 prospective, observational, cohort Consortium of Leaders in the Study of Traumatic Thromboembolism (CLOTT) study of patients aged 18 to 40 years, at 17 US level 1 trauma centers...
January 1, 2023: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/35997730/effect-of-aspirin-vs-enoxaparin-on-symptomatic-venous-thromboembolism-in-patients-undergoing-hip-or-knee-arthroplasty-the-cristal-randomized-trial
#37
RANDOMIZED CONTROLLED TRIAL
Verinder S Sidhu, Thu-Lan Kelly, Nicole Pratt, Stephen E Graves, Rachelle Buchbinder, Sam Adie, Kara Cashman, Ilana Ackerman, Durga Bastiras, Roger Brighton, Alexander W R Burns, Beng Hock Chong, Ornella Clavisi, Maggie Cripps, Mark Dekkers, Richard de Steiger, Michael Dixon, Andrew Ellis, Elizabeth C Griffith, David Hale, Amber Hansen, Anthony Harris, Raphael Hau, Mark Horsley, Dugal James, Omar Khorshid, Leonard Kuo, Peter Lewis, David Lieu, Michelle Lorimer, Samuel MacDessi, Peter McCombe, Catherine McDougall, Jonathan Mulford, Justine Maree Naylor, Richard S Page, John Radovanovic, Michael Solomon, Rami Sorial, Peter Summersell, Phong Tran, William L Walter, Steve Webb, Chris Wilson, David Wysocki, Ian A Harris
IMPORTANCE: There remains a lack of randomized trials investigating aspirin monotherapy for symptomatic venous thromboembolism (VTE) prophylaxis following total hip arthroplasty (THA) or total knee arthroplasty (TKA). OBJECTIVE: To determine whether aspirin was noninferior to enoxaparin in preventing symptomatic VTE after THA or TKA. DESIGN, SETTING, AND PARTICIPANTS: Cluster-randomized, crossover, registry-nested trial across 31 hospitals in Australia...
August 23, 2022: JAMA
https://read.qxmd.com/read/35817368/the-effectiveness-and-safety-of-direct-oral-anticoagulants-compared-to-conventional-pharmacologic-thromboprophylaxis-in-hip-fracture-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#38
REVIEW
Manolis Abatzis-Papadopoulos, Konstantinos Tigkiropoulos, Spyridon Nikas, Ioakeim Papoutsis, Olympia Kostopoulou, Kyriakos Stavridis, Dimitrios Karamanos, Ioannis Lazaridis, Nikolaos Saratzis
BACKGROUND: Direct oral anticoagulants (DOACs) are recommended as a possible pharmacologic venous thromboembolism (VTE) prophylaxis in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, current guidelines did not introduce recommendations for administration of DOACs as an option for pharmacologic VTE prophylaxis in patients undergoing hip fracture surgery (HFS). The purpose of this study is to compare the effectiveness and safety of DOACs administered for pharmacologic VTE prophylaxis in patients undergoing HFS to conventional pharmacologic VTE prophylaxis, as well as mortality between these thromboprophylaxis medications...
July 8, 2022: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://read.qxmd.com/read/35766820/is-aspirin-still-relevant-as-a-single-pharmacological-agent-for-venous-thromboembolism-prophylaxis-post-hip-and-knee-arthroplasty-surgery-a-retrospective-review
#39
JOURNAL ARTICLE
Jacques Pretorius, Nouman Nemat, Imran Azeem, Tony Shaju, Sayed Nadeem, Yasir Hammad
INTRODUCTION: Aspirin is widely used for the prevention of venous thromboembolism (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA). It is well-established that the bleeding and wound complication risk for aspirin is low or equivalent to the other anticoagulant agents, but there is still ongoing controversy regarding the efficacy of aspirin for VTE prophylaxis. The current HSE (2012) guideline suggests 72 h of enoxaparin and 4 weeks of Aspirin therapy. But is this practice still relevant with more recent guidelines, NICE (2021) and SIGN (2014) suggesting that Aspirin is not recommended as a single pharmacological agent for VTE prophylaxis...
2022: SICOT-J
https://read.qxmd.com/read/35530828/a-retrospective-comparative-cohort-study-of-craniotomy-and-prophylactic-enoxaparin-timing
#40
JOURNAL ARTICLE
David R Hallan, Bao Sciscent, Elias Rizk
INTRODUCTION:  Post-operative venous thromboembolism (VTE) prophylaxis is the standard of care after craniotomy, but there is debate over when to initiate VTE prophylaxis to decrease the morbidity and mortality experienced by these patients. This study aims to determine the effects of starting enoxaparin on day one vs. day three after craniotomy. METHODS: We used a multi-institutional health research network (TriNetX) to gather data from the electronic medical records of patients who started enoxaparin one day after craniotomy (cohort 1) and patients who started it three days later (cohort 2)...
April 2022: Curēus
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