Evidence map›Paper›PMID 26815899›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2014

Dalteparin versus Enoxaparin for the prevention of venous thromboembolic events in trauma patients.

O T Okoye, R Gelbard, K Inaba, M Esparza, H Belzberg, P Talving, P G Teixeira, L S Chan, D Demetriades

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In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. The effects of three different low-molecular-weight heparins on blood loss after intramedullary nailing of trochanteric fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

O T OkoyeDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
R GelbardDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
K InabaDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA. kenji.inaba@med.usc.edu.
M EsparzaDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
H BelzbergDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
P TalvingDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
P G TeixeiraDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
L S ChanDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
D DemetriadesDivision of Trauma Surgery and Surgical Critical Care, LAC + USC Medical Center, 2051 Marengo Street, C5L100, Los Angeles, CA, 90033, USA.
LAC+USC Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of low-molecular-weight heparin (LMWH) for the chemoprophylaxis of venous thromboembolism (VTE) in trauma patients is supported by Level-1 evidence. Because Enoxaparin was the agent used in the majority of studies for establishing the efficacy of LMWH in VTE, it remains unclear if Dalteparin provides an equivalent effect.

objectiveTo compare Dalteparin to Enoxaparin and investigate their equivalence as VTE prophylaxis in trauma. PATIENTS/

settingTrauma patients receiving VTE chemoprophylaxis in the Surgical Intensive Care Unit of a Level-1 Trauma Center from 2009 (Enoxaparin) to 2010 (Dalteparin) were included. MEASUREMENTS: The primary outcome was the incidence of clinically significant VTE. Secondary outcomes included heparin-induced thrombocytopenia (HIT), major bleeding, and drug acquisition cost savings. Equivalence margins were set between -5 and 5 %. MAIN

resultsA total of 610 patient records (277 Enoxaparin, 333 Dalteparin) were reviewed. The two study groups did not differ significantly: blunt trauma 67 vs. 62 %, p = 0.27; mean Injury Severity Score (ISS) 17 ± 10 vs. 16 ± 10, p = 0.34; Acute Physiology and Chronic Health Evaluation (APACHE) II score 17 ± 9 vs. 17 ± 10, p = 0.76; time to first dose of LMWH 69 ± 98 vs. 65 ± 67 h, p = 0.57). The rates of deep venous thrombosis (DVT) (3.2 vs. 3.3 %, p = 1.00), pulmonary emboli (PE) (1.8 vs. 1.2 %, p = 0.74), and overall VTE (5.1 vs. 4.5 %, p = 0.85) did not differ. The absolute difference in the incidence of overall VTE was 0.5 % [95 % confidence interval (CI): -2.9, 4.0 %, p = 0.85]. The 95 % CI was within the predefined equivalence margins. There were no significant differences in the frequency of HIT or major bleeding. The total year-on-year cost savings, achieved with 277 patients during the switch to Dalteparin, was estimated to be $107,778.

conclusionsDalteparin is equivalent to Enoxaparin in terms of VTE in trauma patients and can be safely used in this population, with no increase in complications and significant cost savings.

Indexed as

Cost savingsDeep venous thrombosisLow-molecular-weight heparinPulmonary embolismTraumaVenous thromboembolism prophylaxis

Identifiers

PMID26815899
OpenAlexW2016725683

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.