Accession Number:

AD1062074

Title:

Evaluation of Venous Thromboembolism Prevention in High-Risk Trauma Patients: A Prospective, Randomized Trial of Standard Enoxaparin Versus Two Anti-Xa Adjusted Enoxaparin Dosing Strategies

Descriptive Note:

Technical Report,01 Sep 2014,31 Mar 2018

Corporate Author:

CINCINNATI UNIV OH CINCINNATI United States

Personal Author(s):

• Droege,Molly E.
• Droege,Christopher A.
• Webb,Megan L.
• Philpott,Carolyn D.
• Ernst,Neil E.
• Athota,Krishna
• Wakefield,Devin
• Dowd,Joseph R.
• Gomma,Dina
• Robinson,Bryce H.
• Hanseman,Dennis
• Elterman,Joel
• Gerlach,Travis
• Mueller,Eric W.

Report Date:

2018-08-10

Pagination or Media Count:

24.0

Abstract:

The impact of antithrombin III activity AT-III and on prophylactic enoxaparin serum trough anti-factor Xa concentration anti-Xa has not been evaluated. In addition, the optimal strategy for enoxaparin dose adjustment to attain target anti-Xa trough concentrations is unknown in high-risk trauma patients. The objective of this study was to determine if AT-III activity affects enoxaparin anti-Xa target attainment and to evaluate two enoxaparin dose adjustment strategies in patients with low anti-Xa concentrations. We conducted a single-center, prospective, randomized clinical trial of adult, high-risk trauma patients admitted to a level 1 trauma center over a 2-year period. Patients were eligible for inclusion if prescribed enoxaparin 30 mg subcutaneously every 12 hours for venous thromboembolism chemoprophylaxis based on a Greenfield Risk Assessment Profile score of 5 or more. Coordinated serum AT-III, anti-Xa, and thromboeslastogram samples were drawn 8 hours after the third dose of enoxaparin. Patients with anti-Xa 0.1 IUmL served as the control group, while patients with anti-Xa 0.1 IUmL were the intervention group. Intervention group patients were randomized to one of two dose adjustment strategies 1 enoxaparin 40 mg every 12 hours with escalation to 50 mg every 12 hours based on repeat anti-Xa group 1 or 2 enoxaparin 30 mg every 8 hours group 2. In total, 103 patients were studied..

Descriptors:

• cells coagulation factor inhibitors analysis transfusions
• spine
• embolism and thrombosis
• bone fractures
• blood transfusions
• anticoagulants
• clinical trials
• blood coagulation factor inhibitors
• blood cells
• blood

Subject Categories:

• Medicine and Medical Research
• Pharmacology

Distribution Statement:

APPROVED FOR PUBLIC RELEASE