Benefits and risks of preventing thromboembolism with enoxaparin in patients with general surgery in real world--the CLEVER study.
BACKGROUND
We aimed to document enoxaparin use in real world and identify the risk factors for bleeding complications.


METHODS
Postauthorization study in 448 surgical patients receiving enoxaparin prophylaxis. Complete compression ultrasound (CCUS) was performed at day 10 ± 3.


RESULTS
During treatment, 11 of 448 patients had suspected deep venous thrombosis (DVT) but none confirmed. One patient had symptoms of pulmonary embolism ([PE] 0.22%; 95% confidence interval [CI] -0.21-0.66). There were no asymptomatic cases detected upon CCUS. At the 90-day follow-up, 4 (0.9%) of the 440 patients had DVT symptoms (95% CI 0.02-1.80) and none had PE; 5.4% had major and 11.6% any type of bleeding complications. Major bleeding was more frequent in those with kidney disease (odds ratio [OR] 5.53), those who are bedridden (OR 5.49), those with peridural indwelling catheters (OR 4.01), and those on nonsteroidal anti-inflammatory drugs (OR 3.33).


CONCLUSIONS
Enoxaparin is effective and safe in surgical patients to prevent venous thromboembolism.
Klinikum Friedrichstadt, Dresden, Germany. schellong-se@khdf.de
Sebastian M
SM
Schellong
Albrecht
A
Encke
Artur-Aaron
AA
Weber
Peter
P
Bramlage
W Dieter
WD
Paar
Sylvia
S
Haas
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D017984:Enoxaparin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control
D000925:Anticoagulants; D017984:Enoxaparin