Dalteparin versus Enoxaparin for the prevention of venous thromboembolic events in trauma patients

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
O T OkoyeD Demetriades

Abstract

The use of low-molecular-weight heparin (LMWH) for the chemoprophylaxis of venous thromboembolism (VTE) in trauma patients is supported by Level-1 evidence. Because Enoxaparin was the agent used in the majority of studies for establishing the efficacy of LMWH in VTE, it remains unclear if Dalteparin provides an equivalent effect. To compare Dalteparin to Enoxaparin and investigate their equivalence as VTE prophylaxis in trauma. Trauma patients receiving VTE chemoprophylaxis in the Surgical Intensive Care Unit of a Level-1 Trauma Center from 2009 (Enoxaparin) to 2010 (Dalteparin) were included. The primary outcome was the incidence of clinically significant VTE. Secondary outcomes included heparin-induced thrombocytopenia (HIT), major bleeding, and drug acquisition cost savings. Equivalence margins were set between -5 and 5 %. A total of 610 patient records (277 Enoxaparin, 333 Dalteparin) were reviewed. The two study groups did not differ significantly: blunt trauma 67 vs. 62 %, p = 0.27; mean Injury Severity Score (ISS) 17 ± 10 vs. 16 ± 10, p = 0.34; Acute Physiology and Chronic Health Evaluation (APACHE) II score 17 ± 9 vs. 17 ± 10, p = 0.76; time to first dose of LMWH 69 ± 98 vs. 65 ± 67 h, p = 0.57). The rates of deep venou...Continue Reading

References

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Citations

Feb 17, 2015·The American Journal of Emergency Medicine·Takayuki TairaSadaki Inokuchi
Sep 7, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Takeshi OmoriMasato Sakon
Nov 3, 2016·Current Opinion in Critical Care·Philbert Y Van, Martin A Schreiber

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