Key result
Uncapped weight-based heparin achieved therapeutic aPTT within 24 hours in 61.7% of morbidly obese vs 70.7% of non-obese patients (HR 0.87; 95% CI 0.62-1.21; p=0.41).
Why the study?
Controversy exists regarding the use of dose capping of weight-based unfractionated heparin infusions in obese and morbidly obese patients.
Does unfractionated heparin infusion based on actual body weight without dose capping achieve similar time to therapeutic aPTT in obese and morbidly obese patients compared to non-obese patients with acute VTE?
Cohort (n=423)
No
Does unfractionated heparin infusion based on actual body weight without dose capping achieve similar time to therapeutic aPTT in obese and morbidly obese patients compared to non-obese patients with acute VTE?
Hazard Ratio: 0.87 (95% CI 0.62–1.21)
Absolute Event Rate: 61.7% vs 70.7%
p-value: p=0.41
Unfractionated heparin dosing based on actual body weight without a dose cap is safe and effective for achieving therapeutic aPTT in obese and morbidly obese patients with VTE.
No takes yet. Share an insight, caveat, or question.
May support uncapped heparin dosing in obese VTE; observational data leaves open need for randomized confirmation.
Shlensky et al. (2019) conducted a cohort in acute venous thromboembolism (VTE) (n=423). Morbid obesity (BMI ⩾ 40 kg/m2) vs. Non-obese (BMI < 30 kg/m2) was evaluated on therapeutic aPTT within 24 hours (HR 0.87, 95% CI 0.62-1.21, p=0.41). Uncapped weight-based heparin achieved therapeutic aPTT within 24 hours in 61.7% of morbidly obese vs 70.7% of non-obese patients (HR 0.87; 95% CI 0.62-1.21; p=0.41).
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