title: Prolonged thromboprophylaxis with enoxaparin in early neurological rehabilitation.
abstract: Prevention of venous thromboembolism (VTE) is essential in neurological patients. Little is known about the optimal duration, efficacy, and safety of prolonged off-label use of low-molecular-weight heparin (LMWH). We enrolled n = 1176 early neurological rehabilitation cases in a retrospective study. In most cases (n = 1151, 97.9%), 4000 anti-Xa (activated coagulation factor X [factor Xa]) units enoxaparin were administered, only 25 received 2000 units for approximately 2 months (mean of 57.5 days). In 969 cases, enoxaparin was administered for more than 2 weeks. Incidence of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) were 0.43% (n = 5) and 1.11% (n = 13), respectively. Hemorrhages during enoxaparin therapy were more frequent. Bleeding occurred in 1.96% (n = 23) of cases, mainly gastrointestinal, urinary tract, and vitreous body bleeding. In short-term (up to 2 weeks) treatment, bleeding and VTE were more frequent than in long-term treatment. Results from this study suggest that prolonged enoxaparin thromboprophylaxis in neurological rehabilitation is safe and effective.
authors.affiliation: BDH-Neurological Center Hessisch Oldendorf, Teaching Hospital of the Medical School Hanover, InFo Institute, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lang
authors.forename: Carsten
authors.initials: C
authors.lastname: Kienitz
authors.forename: Petra
authors.initials: P
authors.lastname: Wetzel
authors.forename: Jens D
authors.initials: JD
authors.lastname: Rollnik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D017984:Enoxaparin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000097:blood / Q000453:epidemiology / Q000534:rehabilitation*; D011655:Pulmonary Embolism / Q000139:chemically induced / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin