Benefits and risks of preventing thromboembolism with enoxaparin in patients with general surgery in real world--the CLEVER study.

Abstract

BACKGROUND:

We aimed to document enoxaparin use in real world and identify the risk factors for bleeding complications.

METHODS:

Postauthorization study in 448 surgical patients receiving enoxaparin prophylaxis. Complete compression ultrasound (CCUS) was performed at day 10 ± 3.

RESULTS:

During treatment, 11 of 448 patients had suspected deep venous thrombosis (DVT) but none confirmed. One patient had symptoms of pulmonary embolism ([PE] 0.22%; 95% confidence interval [CI] -0.21-0.66). There were no asymptomatic cases detected upon CCUS. At the 90-day follow-up, 4 (0.9%) of the 440 patients had DVT symptoms (95% CI 0.02-1.80) and none had PE; 5.4% had major and 11.6% any type of bleeding complications. Major bleeding was more frequent in those with kidney disease (odds ratio [OR] 5.53), those who are bedridden (OR 5.49), those with peridural indwelling catheters (OR 4.01), and those on nonsteroidal anti-inflammatory drugs (OR 3.33).

CONCLUSIONS:

Enoxaparin is effective and safe in surgical patients to prevent venous thromboembolism.

• Authors: Sebastian M Schellong, Albrecht Encke, Artur-Aaron Weber, Peter Bramlage, W Dieter Paar, Sylvia Haas
• Journal: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis (Clin Appl Thromb Hemost) Vol. 19 Issue 3 Pg. 282-8 (Jun 2013) ISSN: 1938-2723 [Electronic] United States
• PMID: 23064219 (Publication Type: Journal Article)

Chemical References

• Anticoagulants
• Enoxaparin

Topics

• Adult
• Aged
• Anticoagulants (therapeutic use)
• Enoxaparin (adverse effects, therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Venous Thromboembolism (epidemiology, prevention & control)
• Venous Thrombosis (prevention & control)