Carlos Cordova-Cassia1, Daniel Wong1, Mary B Cotter2, Thomas E Cataldo1, Vitaliy Y Poylin3. 1. Colon and Rectal Surgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, USA. 2. HMFP Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, USA. 3. Gastrointestinal and Oncologic Surgery, Feinberg School of Medicine, Northwestern Medical Group, Arkes Family Pavilion, 676 North St Clair Street, Suite 650, Chicago, IL, 60611, USA. vitaliy.poylin2@nm.org.
Abstract
BACKGROUND: Venous thromboembolic events (VTE) continue to be a major source of morbidity following colorectal surgery. Selective extended VTE prophylaxis for high-risk patients is recommended; however, provider compliance is low. The purpose of this study is to evaluate whether the "global" extended use of enoxaparin in all colorectal patients is feasible and safe. METHODS: This is a prospective study conducted at a tertiary care center. All Patients undergoing elective colorectal procedures from November 1, 2017 to October 31, 2018 were discharged on 30 days of enoxaparin. Safety of use and patient compliance were examined. RESULTS: Total of 270 patients received extended prophylaxis during the study period (100% of intended patients) with five VTE recorded (1.85%). There was no significant difference in rates of VTE or complications when compared to years of selective prophylaxis (1.26% for 2016, 2.32% for 2017). Only 64% of patients reported full compliance. CONCLUSION: Global use of extended enoxaparin prophylaxis is safe, but does not decrease rates of VTE when compared to selective use. Patient's non-adherence is likely a significant contributing factor.
BACKGROUND: Venous thromboembolic events (VTE) continue to be a major source of morbidity following colorectal surgery. Selective extended VTE prophylaxis for high-risk patients is recommended; however, provider compliance is low. The purpose of this study is to evaluate whether the "global" extended use of enoxaparin in all colorectal patients is feasible and safe. METHODS: This is a prospective study conducted at a tertiary care center. All Patients undergoing elective colorectal procedures from November 1, 2017 to October 31, 2018 were discharged on 30 days of enoxaparin. Safety of use and patient compliance were examined. RESULTS: Total of 270 patients received extended prophylaxis during the study period (100% of intended patients) with five VTE recorded (1.85%). There was no significant difference in rates of VTE or complications when compared to years of selective prophylaxis (1.26% for 2016, 2.32% for 2017). Only 64% of patients reported full compliance. CONCLUSION: Global use of extended enoxaparin prophylaxis is safe, but does not decrease rates of VTE when compared to selective use. Patient's non-adherence is likely a significant contributing factor.
Authors: Christoph Kalka; David Spirk; Klaus-Arno Siebenrock; Urs Metzger; Philipp Tuor; Daniel Sterzing; Kurt Oehy; Daniela Wondberg; El Yazid Mouhsine; Emanuel Gautier; Nils Kucher Journal: Thromb Haemost Date: 2009-07 Impact factor: 5.249