Jose A. Nieto, PhD; Reina Valle, PhD; Juan B. Lopez-Saez, PhD
Potential Conflicts of Interest: None disclosed.
Nieto JA, Valle R, Lopez-Saez JB. Extended-Duration Venous Thromboembolism Prophylaxis for Medical Patients. Ann Intern Med. 2010;153:688-689. doi: 10.7326/0003-4819-153-10-201011160-00019
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Published: Ann Intern Med. 2010;153(10):688-689.
TO THE EDITOR:
In the excellent EXCLAIM (Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization) study, Hull and coworkers (1) reported on the benefits of a fixed dose of 40 mg of enoxaparin on the extended duration of thromboembolism prophylaxis for patients with level 1 immobility, women, and patients older than 75 years. We hypothesize that the better outcomes observed in the last 2 groups are dependent on the weight-adjusted dosage of enoxaparin administered.
According to RIETE (Registro Informatizado de Enfermedad Tromboembólica) registry data, women (older than 40 years) with venous thromboembolism (VTE) weighed significantly less than men (mean weight, 70.5 kg vs. 77.5 kg; P < 0.001) and patients older than 75 years weighed significantly less than younger patients (mean age, 76.7 years vs. 69.6 years; P < 0.001). As a result, the weight-adjusted dosage of enoxaparin administered may fluctuate by 10%.
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