Heparin versus enoxaparin for prevention of venous thromboembolism after trauma: A randomized noninferiority trial

The Journal of Trauma and Acute Care Surgery
Erik J OlsonC Beth Sise

Abstract

Research comparing enoxaparin with unfractionated heparin (UFH) given every 12 hours for venous thromboembolism (VTE) prophylaxis after trauma overlooks original recommendations that UFH be given every 8 hours. We conducted a prospective, randomized, noninferiority trial comparing UFH every 8 hours and standard enoxaparin every 12 hours. We hypothesized that the incidence of VTE in trauma patients receiving UFH every 8 hours would be no more than 10% higher than that in patients receiving enoxaparin every 12 hours. Trauma patients who met criteria for VTE prophylaxis at a Level I trauma center were randomly assigned to 5,000-U UFH every 8 hours or 30-mg enoxaparin every 12 hours between November 2012 and September 2014. Surveillance duplex ultrasound was performed twice weekly on intensive care unit patients and weekly on ward patients. Primary end points were deep vein thrombosis diagnosed by duplex ultrasound and pulmonary embolism diagnosed by computed tomography angiography. Of 495 randomized patients, 220 received UFH and 216 received enoxaparin for analysis. Overall, 105 in the UFH group and 103 in the enoxaparin group underwent VTE surveillance or diagnostic testing. In the analysis of randomized patients who received tr...Continue Reading

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Citations

Aug 5, 2016·The Journal of Trauma and Acute Care Surgery·George A SingerEdward B Lineen
Sep 7, 2018·Military Medicine·Daniel J GraboMatthew Tadlock
Jul 13, 2019·The Journal of Trauma and Acute Care Surgery·David SkarupaBellal Joseph
Sep 11, 2019·Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses·Hyunmin David Yu
Apr 21, 2017·The Journal of Trauma and Acute Care Surgery·Benjamin N JacobsMark R Hemmila
Jun 10, 2017·The Journal of Trauma and Acute Care Surgery·Jason B BrillSteven R Shackford
Aug 26, 2020·Journal of Burn Care & Research : Official Publication of the American Burn Association·Alice LiuHaig A Yenikomshian
Jul 20, 2020·Blood Reviews·Yaqiu SangDana Huskens
Sep 6, 2020·The Journal of Trauma and Acute Care Surgery·Kristen T CarterMatthew E Kutcher
Jan 29, 2020·The Journal of Surgical Research·Erica N KrantzChristopher A Droege
May 28, 2021·Trauma Surgery & Acute Care Open·Navpreet K DhillonEric J Ley
Apr 27, 2021·The Journal of Trauma and Acute Care Surgery·Kyle D ChecchiVishal Bansal
Sep 8, 2021·Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses·Carol SanchezAdel Elkbuli

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