دورية أكاديمية
أعرض في EDS

Standard dosing of enoxaparin versus unfractionated heparin in critically ill patient with COVID-19: a multicenter propensity-score matched study.

التفاصيل البيبلوغرافية
العنوان: Standard dosing of enoxaparin versus unfractionated heparin in critically ill patient with COVID-19: a multicenter propensity-score matched study.
المؤلفون: Al Sulaiman K; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia. alsulaimankh@hotmail.com.; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. alsulaimankh@hotmail.com.; King Abdullah International Medical Research Center (KAIMRC), PO Box 22490, 11426, Riyadh, Saudi Arabia. alsulaimankh@hotmail.com.; Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia. alsulaimankh@hotmail.com., Aljuhani O; Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia., Korayem GB; Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia., Hafiz A; Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia., Alalawi M; Department of Pharmaceutical Sciences, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia., Badreldin HA; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia.; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center (KAIMRC), PO Box 22490, 11426, Riyadh, Saudi Arabia., Altebainawi AF; Pharmaceutical Care Services, King Khalid Hospital, Hail Health Cluster, Hail, Saudi Arabia., Vishwakarma R; Norwich Medical School, University of East Anglia, Norwich, United Kingdom., Alissa A; Pharmaceutical Care Services, King Abdulla bin Abdulaziz University Hospital, Riyadh, Saudi Arabia., Alghamdi A; Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia., Alenazi AA; Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Al Enazi H; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia., Alanazi S; Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia., Alhammad A; Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia., Alghamdi J; Saudi Food and Drug Authority, Riyadh, Saudi Arabia., AlFaifi M; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia., Al Sehli FA; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia.; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center (KAIMRC), PO Box 22490, 11426, Riyadh, Saudi Arabia., Aldossari MA; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia., Alhubaishi AA; Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia., Al-Ali AY; Pharmaceutical Care Department, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia., Al-Dorzi HM; Intensive Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
المصدر: Thrombosis journal [Thromb J] 2022 Dec 08; Vol. 20 (1), pp. 74. Date of Electronic Publication: 2022 Dec 08.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101170542 Publication Model: Electronic Cited Medium: Print ISSN: 1477-9560 (Print) Linking ISSN: 14779560 NLM ISO Abbreviation: Thromb J Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2003-
مستخلص: Background: Thrombotic events are common in critically ill patients with COVID-19 and have been linked with COVID-19- induced hyperinflammatory state. In addition to anticoagulant effects, heparin and its derivatives have various anti-inflammatory and immunomodulatory properties that may affect patient outcomes. This study compared the effectiveness and safety of prophylactic standard-doses of enoxaparin and unfractionated heparin (UFH) in critically ill patients with COVID-19.  METHODS: A multicenter, retrospective cohort study included critically ill adult patients with COVID-19 admitted to the ICU between March 2020 and July 2021. Patients were categorized into two groups based on the type of pharmacological VTE thromboprophylaxis given in fixed doses (Enoxaparin 40 mg SQ every 24 hours versus UFH 5000 Units SQ every 8 hours) throughout their ICU stay. The primary endpoint was all cases of thrombosis. Other endpoints were considered secondary. Propensity score (PS) matching was used to match patients (1:1 ratio) between the two groups based on the predefined criteria. Multivariable logistic, Cox proportional hazards, and negative binomial regression analysis were used as appropriate.  RESULTS: A total of 306 patients were eligible based on the eligibility criteria; 130 patients were included after PS matching (1:1 ratio). Patients who received UFH compared to enoxaparin had higher all thrombosis events at crude analysis (18.3% vs. 4.6%; p-value = 0.02 as well in logistic regression analysis (OR: 4.10 (1.05, 15.93); p-value = 0.04). Although there were no significant differences in all bleeding cases and major bleeding between the two groups (OR: 0.40 (0.07, 2.29); p-value = 0.31 and OR: 1.10 (0.14, 8.56); p-value = 0.93, respectively); however, blood transfusion requirement was higher in the UFH group but did not reach statistical significance (OR: 2.98 (0.85, 10.39); p-value = 0.09). The 30-day and in-hospital mortality were similar between the two groups at Cox hazards regression analysis. In contrast, hospital LOS was longer in the UFH group; however, it did not reach the statistically significant difference (beta coefficient: 0.22; 95% CI: -0.03, 0.48; p-value = 0.09).
Conclusion: Prophylactic enoxaparin use in critically ill patients with COVID-19 may significantly reduce all thrombosis cases with similar bleeding risk compared to UFH.
(© 2022. The Author(s).)
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فهرسة مساهمة: Keywords: Bleeding; COVID-19; Critically ill; DVT prophylaxis; Enoxaparin; Intensive Care Units (ICUs); Mortality; SARS-Cov-2; Thrombosis; Unfractionated Heparin
تواريخ الأحداث: Date Created: 20221209 Latest Revision: 20221212
رمز التحديث: 20221212
مُعرف محوري في PubMed: PMC9733230
DOI: 10.1186/s12959-022-00432-9
PMID: 36482388
قاعدة البيانات: MEDLINE
الوصف
تدمد:1477-9560
DOI:10.1186/s12959-022-00432-9