title: Effectiveness and safety of thromboprophylaxis with enoxaparin in medical inpatients.
abstract: BACKGROUND
  Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism. Although effective prophylaxis exists for medical patients, there is little information outside of clinical trials. We will analyze our experience in the prophylaxis of VTE with enoxaparin in hospitalized medical patients.
  
  
  METHODS
  We studied all of the patients ≥15 years admitted for emergency care to all of the medical departments of the hospital, except for the Hematology Department, between 1/April/1999 and 31/December/2005. The patients' age, sex, Charlson comorbidity index (CCI), whether they received prophylaxis with enoxaparin or not, dose, VTE, bleeding, thrombocytopenia, and mortality were analyzed.
  
  
  RESULTS
  40,349 patients were included, of which 55.87% were male, with an average age of 67.56, and an average CCI of 4.99. There were 19,834 patients who did not receive prophylaxis for which the rate of incidence of VTE was 0.61%, mortality 8.75%, bleeding 1.38%, and thrombocytopenia 0.04%. Prophylactic enoxaparin was administered to 20,515 patients, for which the rate of incidence of VTE was 0.44%, mortality 10.71%, bleeding 1.1%, and thrombocytopenia 0.04%. The adjusted Odds Ratio (OR) for VTE was 0.65 (95% confidence interval [95% CI] 0.49 to 0.87). The adjusted OR for mortality was 0.84 (95% CI 0.78 to 0.9). With the adjusted data, the number needed to treat (NNT) for VTE was 470.3 (95% CI 278.4 to 1413.3), and the NNT for mortality was 77.2 (95% CI 54.6 to 130.3).
  
  
  CONCLUSIONS
  Thromboprophylaxis with enoxaparin in hospitalized medical patients is associated with a lower incidence of VTE and mortality, and is safe.
authors: Internal Medicine Service, Hospital Universitario Príncipe de Asturias. Alcalá de Henares, Madrid, Spain.
authors: Eduardo
authors: E
authors: Montero Ruiz
authors: Gema
authors: G
authors: Baldominos Utrilla
authors: Joaquín
authors: J
authors: López Álvarez
authors: Rosario
authors: R
authors: Santolaya Perrin
mesh_terms: D000368:Aged; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D017984:Enoxaparin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D011292:Premedication / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control
chemical_list: D017984:Enoxaparin