{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T20:47:38Z","timestamp":1789159658259,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>Enoxaparin is standard of care for venous thromboembolism (VTE) prophylaxis in adult trauma patients, but fixed\u2010dose protocols are suboptimal. Dosing based on body mass index (BMI) or total body weight (TBW) improves target prophylactic anti\u2010Xa level attainment and reduces VTE rates. A novel strategy using estimated blood volume (EBV) may be more effective based on results of a single\u2010center study. This study compared BMI\u2010, TBW\u2010, EBV\u2010based, and hybrid enoxaparin dosing strategies at achieving target prophylactic anti\u2010Factor Xa (anti\u2010Xa) levels in trauma patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Multicenter, retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p>Electronic health records from participating institutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Adult trauma patients who received enoxaparin twice daily for VTE prophylaxis and had at least one appropriately timed anti\u2010Xa level (collected 3 to 6 hours after the previous dose after three consecutive doses) from January 2017 through December 2020. Patients were excluded if the hospital\u2010specific dosing protocol was not followed or if they had thermal burns with &gt; 20% body surface area involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Dosing strategy used to determine initial prophylactic dose of enoxaparin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary end point was percentage of patients with peak anti\u2010Xa levels within the target prophylactic range (0.2\u20100.4 units\/mL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Results<\/jats:title><jats:p>Nine hospitals enrolled 742 unique patients. The most common dosing strategy was based on BMI (43.0%), followed by EBV (29.0%). Patients dosed using EBV had the highest percentage of target anti\u2010Xa levels (72.1%). Multiple logistic regression demonstrated EBV\u2010based dosing was significantly more likely to yield anti\u2010Xa levels at or above target compared to BMI\u2010based dosing (adjusted odds ratio (aOR) 3.59, 95% confidence interval (CI) 2.29\u20105.62, p &lt; 0.001). EBV\u2010based dosing was also more likely than hybrid dosing to yield an anti\u2010Xa level at or above target (aOR 2.30, 95% CI 1.33\u20103.98, p = 0.003). Other pairwise comparisons between dosing strategy groups were nonsignificant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An EBV\u2010based dosing strategy was associated with higher odds of achieving anti\u2010Xa level within target range for enoxaparin VTE prophylaxis compared to BMI\u2010based dosing and may be a preferred method for VTE prophylaxis in adult trauma patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2904","type":"journal-article","created":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T20:55:17Z","timestamp":1703624117000},"page":"258-267","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multicenter study evaluating target attainment of <scp>anti\u2010Factor<\/scp> Xa levels using various enoxaparin prophylactic dosing practices in adult trauma patients"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2326-4629","authenticated-orcid":false,"given":"Tyler","family":"Chanas","sequence":"first","affiliation":[{"name":"ECU Health Medical Center  Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3443-5371","authenticated-orcid":false,"given":"Gabrielle","family":"Gibson","sequence":"additional","affiliation":[{"name":"Barnes\u2010Jewish Hospital  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6504-2066","authenticated-orcid":false,"given":"Elizabeth","family":"Langenstroer","sequence":"additional","affiliation":[{"name":"ECU Health Medical Center  Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6704-6591","authenticated-orcid":false,"given":"David J.","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Froedtert &amp; The Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9904-2152","authenticated-orcid":false,"given":"Thomas W.","family":"Carver","sequence":"additional","affiliation":[{"name":"Froedtert &amp; The Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4709-4019","authenticated-orcid":false,"given":"Kaitlin","family":"Alexander","sequence":"additional","affiliation":[{"name":"University of Florida College of Pharmacy  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0407-8481","authenticated-orcid":false,"given":"Sai Ho Jason","family":"Chui","sequence":"additional","affiliation":[{"name":"University of Maryland Medical Center  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Rein","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5450-4528","authenticated-orcid":false,"given":"Michael","family":"Ha","sequence":"additional","affiliation":[{"name":"UMass Memorial Medical Center  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaylee M.","family":"Maynard","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6656-3212","authenticated-orcid":false,"given":"Kristen","family":"Bamberg","sequence":"additional","affiliation":[{"name":"Flagstaff Medical Center  Flagstaff Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1905-5100","authenticated-orcid":false,"given":"Mary","family":"O'Keefe","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"O'Brien","sequence":"additional","affiliation":[{"name":"UMass Memorial Medical Center  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariela Cardona","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bayview Medical Center  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4663-0265","authenticated-orcid":false,"given":"Brandon","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Orlando Regional Medical Center  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrnaz","family":"Pajoumand","sequence":"additional","affiliation":[{"name":"University of Maryland Medical Center  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1550-6827","authenticated-orcid":false,"given":"William J.","family":"Peppard","sequence":"additional","affiliation":[{"name":"Froedtert &amp; The Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199412153312401"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(89)90182-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2008.10.002"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e3283196538"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609053351003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001321"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2020-000643"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200207000-00032"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002830"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003475"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481808400672"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.1662"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003418"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13169"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001193"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003580"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005754"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016683970"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481508100625"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.03.001"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001142"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003707"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2665"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxad119"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.07.020"},{"issue":"2","key":"e_1_2_7_27_1","first-page":"224","article-title":"Prediction of blood volume in normal adults","volume":"51","author":"Nadler SB","year":"1962","journal-title":"Surgery"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000180580"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.10.028"},{"key":"e_1_2_7_30_1","first-page":"874","article-title":"Standard prophylactic enoxaparin dosing leads to inadequate anti\u2010Xa levels and increased deep venous thrombosis rates in critically ill trauma and surgical patients","volume":"68","author":"Malinoski D","year":"2010","journal-title":"J Trauma"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.10.005"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.02.034"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.07.038"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182788fa7"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.03.020"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2526"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199222050-00003"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.2146\/sp150027"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.01.018"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/10600280231169523"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003738"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.3357\/AMHP.5255.2019"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2013-0572-OA"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003134820949519"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2904","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T10:23:47Z","timestamp":1761042227000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,8]]},"references-count":43,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/phar.2904"],"URL":"https:\/\/doi.org\/10.1002\/phar.2904","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,8]]},"assertion":[{"value":"2023-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}