Prevention of venous thromboembolism in medical patients with enoxaparin

Alikhan, Raza; Cohen, Alexander T.; Combe, S.; Samama, M; Desjardins, Louis; Eldor, Amiram; Janbon, C; Leizorovicz, Alain; Olsson, Carl; Turpie, Alexander G.G.

doi:10.1097/00001721-200306000-00004

Cited by 246 publications

(176 citation statements)

References 15 publications

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“…Observations with diverticulitis were selected as a comparison group because they also had an inflammatory colorectal condition, although the process is localized as opposed to systemic as in UC. Observations with respiratory failure were selected as another comparison group because these are nonsurgical patients considered to be at high risk for venous thromboembolic events [7] and are recommended to receive routine thromboembolic prophylaxis when admitted to the hospital. The surgical groups included any observations with UC, diverticulitis, or colorectal cancer (ICD-9 CM code 153, 153.0-153.9, 154, 154.0, 154.1), which also had a procedure code for any colorectal operation (ICD-9 CM procedure code 457, 457.…”

Section: Identification Of Casesmentioning

confidence: 99%

Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events

Wang¹,

Terdiman²,

Vittinghoff³

et al. 2009

WJG

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AIM:To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS:Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS:Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have significantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer. CONCLUSION:Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.

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Section: Identification Of Casesmentioning

confidence: 99%

Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events

Wang¹,

Terdiman²,

Vittinghoff³

et al. 2009

WJG

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“…Subgroup analyses of studies have confirmed that a wide range of moderate-to high-risk medical patients, in particular elderly patients and patients with heart failure or respiratory failure, benefit from thromboprophylaxis. 40 Parameters for selecting the appropriate patients to treat are shown in Table 4.…”

Section: B Which Patients Should Be Selected For Treatment?mentioning

confidence: 99%

Preventing Venous Thromboembolism in Medical Patients

Leizorovicz

Mismetti

2004

Circulation

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Abstract-Given the increased number of patients hospitalized for acute medical illnesses and the associated risk of venous thromboembolism (VTE), the use of prophylaxis has become a public health matter. Thromboprophylaxis is not widely practiced in acutely ill medical patients, due in part to the heterogeneity of this group and the perceived difficulty in assessing those who would most benefit from treatment. Nevertheless, the results of recent well-conducted clinical trials support the evidence-based recommendations for more widespread systematic use of low-dose low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) in this population. Three large well-controlled studies (MEDENOX, PREVENT, and ARTEMIS) in acutely ill medical patients confirm previous findings that different at-risk patient populations show a consistent 50% reduction in VTE events with LMWH and fondaparinux. A meta-analysis in nearly 5000 patients in internal medicine comparing UFH and LMWH revealed a trend for reduction of deep vein thrombosis and pulmonary embolism with LMWH. Based on duration of use in clinical trials in acutely ill medical patients, prophylactic treatment with UFH and LMWH is recommended for 2 weeks.

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“…It is generally accepted that patients with CHF are characterized by an increased risk of VTE. In various studies, the incidence of APE or deep vein thrombosis in the population of patients hospitalized due to CHF ranged from 4% to 14% [18][19][20]. In another study, the incidence of APE in a group of patients with CHF was 9.1% despite adequate use Table 6.…”

Section: Discussionmentioning

confidence: 99%