{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:54:23Z","timestamp":1790052863054,"version":"4.0.1"},"reference-count":11,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients admitted after traumatic injuries are at high risk for developing venous thromboembolism (VTE). Low-molecular-weight heparin (LMWH) is commonly used to prevent VTE in this patient population; however, the optimal dosing strategy has yet to be determined. To address this question, a fixed-dosing strategy of LMWH was compared to a weight-based dosing strategy of LMWH for VTE prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective, pre-post implementation cohort study compared a fixed vs a weight-based dosing strategy of LMWH for VTE prophylaxis. Patients admitted to our level 1 trauma center were included if they had an estimated glomerular filtration rate &gt;30\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      , received at least 3 doses of LMWH, and had an appropriately drawn anti-Xa level on their initial dosing regimen. Patients in the pre-cohort received 30\u00a0mg LMWH subcutaneously twice daily as the initial dosing regimen. Patients in the post-cohort received .5\u00a0mg\/kg (max 60\u00a0mg) LMWH subcutaneously every 12\u00a0h as the initial dosing regimen. A goal anti-Xa of .2-.4 IU\/mL was targeted for prophylaxis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 817 patients in the fixed-dosing group (FDG) and 874 patients in the weight-based dosing group (WBDG). In the FDG, 42.8% of the patients achieved the goal initial anti-Xa level, with 54.1% and 3.1% reaching sub- and supratherapeutic doses, respectively. In the WBDG, 66.5% of patients reached goal initial anti-Xa levels, with 23.5% and 10.1% at sub- and supratherapeutic levels. The distribution of dose ranges was significantly different between the dosing strategies ( P-value &lt;.001). There was no difference in the number of patients who received blood products (39.1% vs 41.7%. P-value = .299).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our study, weight-based dosing of LMWH yielded a significantly higher proportion of patients who achieved goal prophylactic anti-Xa levels than fixed-dosing of LMWH. Larger-scale studies are needed to assess the risk of VTE events and bleeding with these dosing strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348241241620","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T16:25:42Z","timestamp":1711124742000},"page":"1406-1411","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Weight-Based Dosing for Low-Molecular-Weight Heparin (Enoxaparin) Administration to Achieve Optimal VTE Prophylaxis in Trauma Patients"],"prefix":"10.1177","volume":"90","author":[{"given":"Tarendeep","family":"Thind","sequence":"first","affiliation":[{"name":"College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Heye","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curran","family":"Henson","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Reif","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"},{"name":"Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna K.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle J.","family":"Kalkwarf","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2396-2280","authenticated-orcid":false,"given":"Avi","family":"Bhavaraju","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"},{"name":"College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"bibr1-00031348241241620","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2017.09.01"},{"key":"bibr2-00031348241241620","first-page":"1067","author":"Villareal J","year":"2021","journal-title":"The Journal of Foot and Ankle Surgery"},{"key":"bibr3-00031348241241620","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016683970"},{"key":"bibr4-00031348241241620","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199609000-00004"},{"key":"bibr5-00031348241241620","doi-asserted-by":"publisher","DOI":"10.4081\/hr.2015.5844"},{"key":"bibr6-00031348241241620","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.07.020"},{"key":"bibr7-00031348241241620","unstructured":"Kalkwarf K, Oswalt A, Smith R. Venous thromboembolism prophylaxis guidelines for trauma and emergency general surgery. Little Rock, AR: UAMS Medical Center; 2019."},{"key":"bibr8-00031348241241620","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0b013e3182788fa7"},{"key":"bibr9-00031348241241620","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-019-01215-0"},{"key":"bibr10-00031348241241620","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.5977"},{"key":"bibr11-00031348241241620","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.3963"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241241620","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348241241620","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241241620","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:39:11Z","timestamp":1777379951000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348241241620"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,22]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1177\/00031348241241620"],"URL":"https:\/\/doi.org\/10.1177\/00031348241241620","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,22]]}}}