Early vs. late enoxaparin for the prevention of venous thromboembolism in patients with ICH : A double blind placebo controlled multicenter study

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dc.contributor.author Qian, C.
dc.contributor.author Huhtakangas, J.
dc.contributor.author Juvela, S.
dc.contributor.author Bode, M. K.
dc.contributor.author Tatlisumak, T.
dc.contributor.author Savolainen, M.
dc.contributor.author Numminen, H.
dc.contributor.author Ollikainen, J.
dc.contributor.author Luostarinen, L.
dc.contributor.author Kupila, L.
dc.contributor.author Tetri, S.
dc.date.accessioned 2021-06-08T03:45:01Z
dc.date.available 2021-06-08T03:45:01Z
dc.date.issued 2021-03
dc.identifier.citation Qian , C , Huhtakangas , J , Juvela , S , Bode , M K , Tatlisumak , T , Savolainen , M , Numminen , H , Ollikainen , J , Luostarinen , L , Kupila , L & Tetri , S 2021 , ' Early vs. late enoxaparin for the prevention of venous thromboembolism in patients with ICH : A double blind placebo controlled multicenter study ' , Clinical Neurology and Neurosurgery , vol. 202 , 106534 . https://doi.org/10.1016/j.clineuro.2021.106534
dc.identifier.other PURE: 164791749
dc.identifier.other PURE UUID: be8d4106-7ba9-4136-8694-bd43816e6010
dc.identifier.other WOS: 000632970600019
dc.identifier.other ORCID: /0000-0003-4944-4983/work/104949576
dc.identifier.uri http://hdl.handle.net/10138/330705
dc.description.abstract Backround: Venous thromboembolism (VTE) after primary intracerebral hemorrhage (ICH) worsens patient prognosis. Administering low-molecular weight heparins (LMWH) to prevent VTE early (24 h) may increase the risk of hematoma enlargement, whereas administering late (72 h) after onset may decrease its effect on VTE prevention. The authors investigated when it is safe and effective to start LMWH in ICH patients. Methods: In the setting of double blinded, placebo controlled randomization, patients >18 years of age with paretic lower extremity, and admitted to the emergency room within 12 h of the onset of ICH, were randomized into two groups. Patients in the enoxaparin group received 20 mg twice a day 24 h (early) after the onset of ICH and in the placebo group 72 h (late) after onset respectively. Both groups immediately received intermittent pneumatic compression stockings at the ER. Patients were prospectively and routinely screened for VTE and hemorrhagic complications 1 day after entering the study and again before discharge. Results: 139 patients were included for randomization in this study. Only 3 patients developed VTE, 2 in the early enoxaparin group and one in the late enoxaparin group. No patients developed PE. Thromboembolic events (p = 0.901), risk of hematoma enlargement (p = 0.927) and overall outcome (P = 0.904) did not differ significantly between the groups. Conclusion: Administering 40 mg/d LMWH for prevention of VTE to a spontaneous ICH patient is safe regardless of whether it is started 24 h (early) or 72 h (late) after the hemorrhage. Risk of hemorrhage enlargement is not associated with early LMWH treatment. Administering LMWH late did not increase VTEs. en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof Clinical Neurology and Neurosurgery
dc.rights cc_by_nc_nd
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Intracerebral hemorrhage
dc.subject Deep venous thrombosis
dc.subject Thrombosis prophylaxis
dc.subject Low molecular weight heparin
dc.subject Safety
dc.subject 3112 Neurosciences
dc.subject 3124 Neurology and psychiatry
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Early vs. late enoxaparin for the prevention of venous thromboembolism in patients with ICH : A double blind placebo controlled multicenter study en
dc.type Article
dc.contributor.organization HUS Neurocenter
dc.contributor.organization Neurokirurgian yksikkö
dc.contributor.organization Department of Neurosciences
dc.contributor.organization Clinicum
dc.contributor.organization University of Helsinki
dc.contributor.organization Neurologian yksikkö
dc.contributor.organization HYKS erva
dc.contributor.organization Päijät-Häme Welfare Consortium
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.clineuro.2021.106534
dc.relation.issn 0303-8467
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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