Key result
Prolonged enoxaparin thromboprophylaxis in neurological rehabilitation resulted in low overall rates of symptomatic DVT (0.43%), PE (1.11%), and bleeding (1.96%).
Why the study?
Does prolonged enoxaparin thromboprophylaxis safely prevent venous thromboembolism in early neurological rehabilitation patients compared to short-term treatment?
Cohort (n=1,176)
Does prolonged enoxaparin thromboprophylaxis safely prevent venous thromboembolism in early neurological rehabilitation patients compared to short-term treatment?
Prolonged enoxaparin thromboprophylaxis appears safe and effective for preventing venous thromboembolism in early neurological rehabilitation patients.
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Low VTE/bleeding rates with prolonged enoxaparin support further evaluation; leaves open randomized comparison to short-term prophylaxis in neurological rehabilitation.
Prevention of venous thromboembolism (VTE) is essential in neurological patients. Little is known about the optimal duration, efficacy, and safety of prolonged off-label use of low-molecular-weight heparin (LMWH). We enrolled n = 1176 early neurological rehabilitation cases in a retrospective study. In most cases (n = 1151, 97.9%), 4000 anti-Xa (activated coagulation factor X [factor Xa]) units enoxaparin were administered, only 25 received 2000 units for approximately 2 months (mean of 57.5 days). In 969 cases, enoxaparin was administered for more than 2 weeks. Incidence of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) were 0.43% (n = 5) and 1.11% (n = 13), respectively. Hemorrhages during enoxaparin therapy were more frequent. Bleeding occurred in 1.96% (n = 23) of cases, mainly gastrointestinal, urinary tract, and vitreous body bleeding. In short-term (up to 2 weeks) treatment, bleeding and VTE were more frequent than in long-term treatment. Results from this study suggest that prolonged enoxaparin thromboprophylaxis in neurological rehabilitation is safe and effective.
Lang et al. (2010) conducted a cohort in Early neurological rehabilitation (n=1,176). Prolonged enoxaparin thromboprophylaxis vs. Short-term (up to 2 weeks) treatment was evaluated on Symptomatic deep vein thrombosis (DVT), pulmonary embolism (PE), and bleeding. Prolonged enoxaparin thromboprophylaxis in neurological rehabilitation resulted in low overall rates of symptomatic DVT (0.43%), PE (1.11%), and bleeding (1.96%).
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