Adjusted value of thromboprophylaxis in hospitalized obese patients: A comparative study of two regimens of enoxaparin: The ITOHENOX study

摘要

Thromboprophylaxis is a mainstay of hospital care in patients at high risk of thrombosis. Fixed doses of lowmolecular-weight heparin (LMWH) are recommended for thromboprophylaxis in patients admitted to hospital for an acute medical condition. However, the distribution of LMWHisweight-based, and the efficacy of standard doses in obese patients may be decreased. Data for obese patients are mainly available in bariatric surgery with extremely obese patientswho are at greater risk of venous thromboembolismthan those hospitalized for amedical condition. Weconducted a randomized control trial inmedically obese inpatients (BMI >= 30 kg/m(2)) assessing two regimens of enoxaparin (40 mg and 60mg SQ daily) in order to determinewhether a stronger dosagewould achieve higher anti-Xa level suitable for thromboprophylaxis. Between September 2013 and April 2015, 91 patients were included in the study (mean (+/- standard deviation) age was 70.4 +/- 10.7 years, average BMI 37.8 +/- 6.4 kg/m(2)). Main indications of thromboprophylaxisweremainly acute infection (50%), acute respiratory failure (10%), acute congestive heart failure (9%) and acute rheumatic disorders (18%).