Evidence map›Paper›PMID 33978907›Full record

Trial reportJournal of thrombosis and thrombolysis2021

Impact of antithrombin III and enoxaparin dosage adjustment on prophylactic anti-Xa concentrations in trauma patients at high risk for venous thromboembolism: a randomized pilot trial.

Molly Elizabeth Droege, Christopher Allen Droege, Carolyn Dosen Philpott, Megan Leslie Webb, Neil Edward Ernst, Krishna Athota, Devin Wakefield, Joseph Richard Dowd, Dina Gomaa, Bryce H R Robinson and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of thrombosis and thrombolysis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02412982 (Evaluation of Venous Thromboembolism Prevention in High-Risk Trauma Patients), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 22% 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.

NCT02412982 phase4completednot on this map

Evaluation of Venous Thromboembolism Prevention in High-Risk Trauma Patients: A Prospective Randomized Trial of Standard Enoxaparin Versus Two Anti-Xa Adjusted Dosing Strategies

TypeinterventionalSponsorUniversity of CincinnatiRan2016 to 2019Enrolled103ConditionsTraumatic Injury, Venous ThromboembolismArmsEnoxaparin 40 mg q12h, Enoxaparin 30 mg q8h
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
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

13 authors at 4 institutions in 1 country.

Molly Elizabeth DroegeUC Health - University of Cincinnati Medical Center, 234 Goodman Street, Mail Location 0740, Cincinnati, OH, USA. Molly.Droege@UCHealth.com.ORCID http://orcid.org/0000-0002-4338-1021
Christopher Allen DroegeUC Health - University of Cincinnati Medical Center, 234 Goodman Street, Mail Location 0740, Cincinnati, OH, USA.
Carolyn Dosen PhilpottUC Health - University of Cincinnati Medical Center, 234 Goodman Street, Mail Location 0740, Cincinnati, OH, USA.
Megan Leslie WebbUC Health - University of Cincinnati Medical Center, 234 Goodman Street, Mail Location 0740, Cincinnati, OH, USA.
Neil Edward ErnstUC Health - University of Cincinnati Medical Center, 234 Goodman Street, Mail Location 0740, Cincinnati, OH, USA.
Krishna AthotaDepartment of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267, USA.
Devin WakefieldDepartment of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267, USA.
Joseph Richard DowdDepartment of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267, USA.
Dina GomaaDepartment of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267, USA.
Bryce H R RobinsonDepartment of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267, USA.
Dennis HansemanDepartment of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267, USA.
Joel EltermanDepartment of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267, USA.
Eric William MuellerUC Health - University of Cincinnati Medical Center, 234 Goodman Street, Mail Location 0740, Cincinnati, OH, USA.
Sabin Vaccine Institute · USUniversity of Cincinnati · USBaptist Health Louisville · USHarborview Medical Center · US

Funding

U.S. Air Force FA8650-14-2-6B30
6 · The paper itself

Abstract

The impact of antithrombin III activity (AT-III) on prophylactic enoxaparin anti-factor Xa concentration (anti-Xa) is unknown in high-risk trauma patients. So too is the optimal anti-Xa-adjusted enoxaparin dosage. This prospective, randomized, pilot study sought to explore the association between AT-III and anti-Xa goal attainment and to preliminarily evaluate two enoxaparin dosage adjustment strategies in patients with subprophylactic anti-Xa. Adult trauma patients with Risk Assessment Profile (RAP) ≥ 5 prescribed enoxaparin 30 mg subcutaneously every 12 h were eligible. AT-III and anti-Xa were drawn 8 h after the third enoxaparin dose and compared between patients with anti-Xa ≥ 0.1 IU/mL (goal; control group) or anti-Xa < 0.1 IU/mL (subprophylactic; intervention group). The primary outcome was difference in baseline AT-III. Subsequently, intervention group patients underwent 1:1 randomization to either enoxaparin 40 mg every 12 h (up to 50 mg every 12 h if repeat anti-Xa < 0.1 IU/mL) (enox12) or enoxaparin 30 mg every 8 h (enox8) with repeat anti-Xa assessments. The proportion of patients achieving goal anti-Xa after dosage adjustment were compared. A total of 103 patients were included. Anti-Xa was subprophylactic in 50.5%. Baseline AT-III (median [IQR]) was 87% [80-98%] in control patients versus 82% [71-96%] in intervention patients (p = 0.092). Goal trough anti-Xa was achieved on first assessment in 38.1% enox12 versus 50% enox8 patients (p = 0.67), 84.6% versus 53.3% on second assessment (p = 0.11), and 100% vs. 54.5% on third trough assessment (p = 0.045). AT-III activity did not differ between high-risk trauma patients with goal and subprophylactic enoxaparin anti-Xa concentrations, although future investigation is warranted. Enoxaparin dose adjustment rather than frequency adjustment may be associated with a higher proportion of patients achieving goal anti-Xa over time.

Indexed as

Venous ThromboembolismAdultAnticoagulantsAntithrombin IIIEnoxaparinHumansPilot ProjectsProspective StudiesAnticoagulantsAntithrombin IIIEnoxaparinAntithrombinAnti-XaDeep vein thrombosisEnoxaparinProphylaxis

Identifiers

PMID33978907
OpenAlexW3163134578

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.