Alnatsheh Abdelmajid H, Beckett Robert D, Waterman Stacy
1 Pharmacy Department, Parkview Regional Medical Center, Fort Wayne, IN, USA.
2 Drug Information Center, Manchester University, Fort Wayne, IN, USA.
J Oncol Pharm Pract. 2019 Jun;25(4):813-817. doi: 10.1177/1078155218760159. Epub 2018 Feb 28.
The purpose of this study is to compare the incidence of venous thromboembolism between obese and non-obese hospitalized patients who received United States Food and Drug Administration-approved prophylactic enoxaparin doses and to describe enoxaparin dosing strategies used in obese patients.
This was a retrospective cohort study including patients who were admitted to Parkview Regional Medical Center, Parkview Hospital, or Parkview Orthopedic Hospital between September 2011 and August 2012 and received at least one dose of enoxaparin 30 mg twice daily or enoxaparin 40 mg once daily for venous thromboembolism prophylaxis. Patients classified based on their body mass index into three groups, Group 1 (non-obese: body mass index < 25 kg/m), Group 2 (overweight: body mass index ≥ 25 kg/m but < 30 kg/m), and Group 3 (obese: body mass index ≥ 30 kg/m). The primary endpoint was venous thromboembolism occurrence within 90 days, considering day 1 of hospitalization as day 1.
Of the 428 patients included, 8 cases of venous thromboembolism (1.9%) were identified; 3 in the non-obese group, 2 in the overweight group, and 3 in the obese group, no statistically significant differences were found between the three groups, p = 0.81. When venous thromboembolism incidence was adjusted for age and sex, no statistically significant differences were found between overweight (OR = 0.685; 95% CI 0.115-4.095), obese (OR = 0.797; 95% CI 0.353-1.796), and combined overweight and obese (OR = 0.656; 95% CI 0.154-2.799) groups compared to patients with normal body weight.
This study did not find a statistically significant difference in venous thromboembolism incidence between obese, overweight, and non-obese hospitalized patients receiving approved enoxaparin prophylaxis doses.
本研究旨在比较接受美国食品药品监督管理局批准的预防剂量依诺肝素的肥胖与非肥胖住院患者静脉血栓栓塞的发生率，并描述肥胖患者使用依诺肝素的给药策略。
这是一项回顾性队列研究，纳入2011年9月至2012年8月间入住帕克维尤地区医疗中心、帕克维尤医院或帕克维尤骨科医院且接受至少一剂依诺肝素（每日两次，每次30mg或每日一次，每次40mg）预防静脉血栓栓塞的患者。根据体重指数将患者分为三组，第1组（非肥胖：体重指数<25kg/m），第2组（超重：体重指数≥25kg/m但<30kg/m），第3组（肥胖：体重指数≥30kg/m）。以住院第1天为第1天，主要终点为90天内静脉血栓栓塞的发生情况。
纳入的428例患者中，共发现8例静脉血栓栓塞（1.9%）；非肥胖组3例，超重组2例，肥胖组3例，三组之间未发现统计学显著差异，p = 0.81。对年龄和性别进行校正后，超重（OR = 0.685；95% CI 0.115 - 4.095）、肥胖（OR = 0.797；95% CI 0.353 - 1.796）以及超重与肥胖合并组（OR = 0.656；95% CI 0.154 - 2.799）与体重正常的患者相比，静脉血栓栓塞发生率无统计学显著差异。
本研究未发现接受批准的依诺肝素预防剂量的肥胖、超重和非肥胖住院患者在静脉血栓栓塞发生率上存在统计学显著差异。
