Enoxaparin dosage and incidence of venous thromboembolism in critically ill patients with COVID-19

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F46747885%3A24530%2F24%3A00013447" target="_blank" >RIV/46747885:24530/24:00013447 - isvavai.cz</a>

Výsledek na webu

<a href="https://aimjournal.cz/en/artkey/aim-202404-0001_enoxaparin-dosage-and-incidence-of-venous-thromboembolism-in-critically-ill-patients-with-covid-19.php" target="_blank" >https://aimjournal.cz/en/artkey/aim-202404-0001_enoxaparin-dosage-and-incidence-of-venous-thromboembolism-in-critically-ill-patients-with-covid-19.php</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.36290/aim.2024.032" target="_blank" >10.36290/aim.2024.032</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Enoxaparin dosage and incidence of venous thromboembolism in critically ill patients with COVID-19

Popis výsledku v původním jazyce

Objective: COVID-19 is associated with a high risk of thromboembolic disease (VTE) and this risk is further increased in critically ill patients. Elevated D-dimer levels are a predictor of severe COVID-19 disease. Data on the incidence of VTE, mortality of critically ill patients with COVID-19, and its association with the dose of prophylactic anticoagulation in Czechia have not been published. We performed a retrospective analysis of patients with COVID-19 admitted to the intensive care unit. The primary endpoint was new-onset deep vein thrombosis during ICU stay. Secondary objectives were incidence of pulmonary embolism, venous thromboembolism (deep vein thrombosis and/or pulmonary embolism), number of episodes of major bleeding, ICU length of stay, ICU lethality, 28-day, 90-day, and 180-day lethality, and duration of artificial pulmonary ventilation. Design: retrospective observational study. Setting: Intensive care units of a large general hospital. Material and methods: We performed a retrospective analysis of medical records of patients hospitalized for COVID-19 in 4 intensive care units of a large general hospital between September 2020 and April 2021. Patients meeting the following inclusion criteria were included for analysis: age at least 18 years, principal diagnosis of COVID-19, length of stay in the ICU at least 72 hours, and absence of VTE on ICU admission. Results: A total of 44 cases (13.3%) of new-onset VTE were identified. A total of 9 patients were diagnosed with pulmonary embolism, 31 patients with deep vein thrombosis, and 4 patients with deep vein thrombosis concomitant with pulmonary embolism. 274 patients received a standard prophylactic dose of enoxaparin, and 56 patients received intermediate or therapeutic doses. ICU, 28-day, 90-day, and 180-day mortality rates were 27%, 32%, 44%, and 47%, respectively. Mortality was not significantly associated with anticoagulant dose. There was a significant association between D-dimer levels and mortality. Conclusion: The incidence of VTE found in a cohort of critically ill patients with COVID-19 was high. Elevated D-dimer levels were associated with 30-day, 90-day, and 180-day mortality. Increased dosing of low-molecular-weight heparin was not associated with a lower incidence of thromboembolism or lower mortality and cannot be recommended.

Název v anglickém jazyce

Enoxaparin dosage and incidence of venous thromboembolism in critically ill patients with COVID-19

Popis výsledku anglicky

Objective: COVID-19 is associated with a high risk of thromboembolic disease (VTE) and this risk is further increased in critically ill patients. Elevated D-dimer levels are a predictor of severe COVID-19 disease. Data on the incidence of VTE, mortality of critically ill patients with COVID-19, and its association with the dose of prophylactic anticoagulation in Czechia have not been published. We performed a retrospective analysis of patients with COVID-19 admitted to the intensive care unit. The primary endpoint was new-onset deep vein thrombosis during ICU stay. Secondary objectives were incidence of pulmonary embolism, venous thromboembolism (deep vein thrombosis and/or pulmonary embolism), number of episodes of major bleeding, ICU length of stay, ICU lethality, 28-day, 90-day, and 180-day lethality, and duration of artificial pulmonary ventilation. Design: retrospective observational study. Setting: Intensive care units of a large general hospital. Material and methods: We performed a retrospective analysis of medical records of patients hospitalized for COVID-19 in 4 intensive care units of a large general hospital between September 2020 and April 2021. Patients meeting the following inclusion criteria were included for analysis: age at least 18 years, principal diagnosis of COVID-19, length of stay in the ICU at least 72 hours, and absence of VTE on ICU admission. Results: A total of 44 cases (13.3%) of new-onset VTE were identified. A total of 9 patients were diagnosed with pulmonary embolism, 31 patients with deep vein thrombosis, and 4 patients with deep vein thrombosis concomitant with pulmonary embolism. 274 patients received a standard prophylactic dose of enoxaparin, and 56 patients received intermediate or therapeutic doses. ICU, 28-day, 90-day, and 180-day mortality rates were 27%, 32%, 44%, and 47%, respectively. Mortality was not significantly associated with anticoagulant dose. There was a significant association between D-dimer levels and mortality. Conclusion: The incidence of VTE found in a cohort of critically ill patients with COVID-19 was high. Elevated D-dimer levels were associated with 30-day, 90-day, and 180-day mortality. Increased dosing of low-molecular-weight heparin was not associated with a lower incidence of thromboembolism or lower mortality and cannot be recommended.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30223 - Anaesthesiology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

ANESTEZIOLOGIE A INTENZIVNI MEDICINA

ISSN

1214-2158

e-ISSN

—

Svazek periodika

35

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

8

Strana od-do

215-222

Kód UT WoS článku

001418854400002

EID výsledku v databázi Scopus

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