Clinical Outcomes With the Use of Prophylactic Versus Therapeutic Anticoagulation in Coronavirus Disease 2019
Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine..
OBJECTIVES: To determine the impact of anticoagulation on inhospital mortality among coronavirus disease 2019-positive patients with the a priori hypothesis that there would be a lower risk of inhospital mortality with use of preemptive therapeutic over prophylactic dose enoxaparin or heparin.
DESIGN SETTING: Retrospective cohort study from April 1, 2020, to April 25, 2020. The date of final follow-up was June 12, 2020 Two large, acute-care hospitals in Western Connecticut.
PATIENTS: Five hundred and one inpatients were identified after discharge as 18 years or older and positive for severe acute respiratory syndrome coronavirus 2. The final sample size included 374 patients after applying exclusion criteria. Demographic variables were collected via hospital billing inquiries, whereas the clinical variables were abstracted from patients' medical records.
EXPOSURE: Preemptive enoxaparin or heparin at a therapeutic or prophylactic dose.
MAIN RESULTS: When comparing treatments through multivariable analysis, risk of inhospital mortality was 2.3 times greater in patients receiving preemptive therapeutic anticoagulation (95% CI = 1.0-4.9; p = 0.04). Additionally, the average treatment effects were higher (β = 0.11, p = 0.01) in the therapeutic group.
CONCLUSIONS: An increase in inhospital mortality was observed among patients on preemptive therapeutic anticoagulation. Thus, in the management of coronavirus disease 2019 and its complications, we recommend further research and cautious use of preemptive therapeutic over prophylactic anticoagulation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:2 |
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| Enthalten in: |
Critical care explorations - 2(2020), 12 vom: 22. Dez., Seite e0309 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Motta, Jishu Kaul [VerfasserIn] |
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| Links: |
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| Themen: |
Anticoagulants; coronavirus; length of stay; mortality; pneumonia; thrombosis |
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| Anmerkungen: |
Date Revised 19.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1097/CCE.0000000000000309 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319191257 |
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| 500 | |a Date Revised 19.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. | ||
| 520 | |a OBJECTIVES: To determine the impact of anticoagulation on inhospital mortality among coronavirus disease 2019-positive patients with the a priori hypothesis that there would be a lower risk of inhospital mortality with use of preemptive therapeutic over prophylactic dose enoxaparin or heparin | ||
| 520 | |a DESIGN SETTING: Retrospective cohort study from April 1, 2020, to April 25, 2020. The date of final follow-up was June 12, 2020 Two large, acute-care hospitals in Western Connecticut | ||
| 520 | |a PATIENTS: Five hundred and one inpatients were identified after discharge as 18 years or older and positive for severe acute respiratory syndrome coronavirus 2. The final sample size included 374 patients after applying exclusion criteria. Demographic variables were collected via hospital billing inquiries, whereas the clinical variables were abstracted from patients' medical records | ||
| 520 | |a EXPOSURE: Preemptive enoxaparin or heparin at a therapeutic or prophylactic dose | ||
| 520 | |a MAIN RESULTS: When comparing treatments through multivariable analysis, risk of inhospital mortality was 2.3 times greater in patients receiving preemptive therapeutic anticoagulation (95% CI = 1.0-4.9; p = 0.04). Additionally, the average treatment effects were higher (β = 0.11, p = 0.01) in the therapeutic group | ||
| 520 | |a CONCLUSIONS: An increase in inhospital mortality was observed among patients on preemptive therapeutic anticoagulation. Thus, in the management of coronavirus disease 2019 and its complications, we recommend further research and cautious use of preemptive therapeutic over prophylactic anticoagulation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a anticoagulants; coronavirus; length of stay; mortality; pneumonia; thrombosis | |
| 700 | 1 | |a Ogunnaike, Rahila O |e verfasserin |4 aut | |
| 700 | 1 | |a Shah, Rutvik |e verfasserin |4 aut | |
| 700 | 1 | |a Stroever, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Cedeño, Harold V |e verfasserin |4 aut | |
| 700 | 1 | |a Thapa, Shyam K |e verfasserin |4 aut | |
| 700 | 1 | |a Chronakos, John J |e verfasserin |4 aut | |
| 700 | 1 | |a Jimenez, Eric J |e verfasserin |4 aut | |
| 700 | 1 | |a Petrini, Joann |e verfasserin |4 aut | |
| 700 | 1 | |a Hegde, Abhijith |e verfasserin |4 aut | |
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