{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:22:56Z","timestamp":1747196576429,"version":"3.40.5"},"reference-count":10,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Low molecular weight heparin has proven to be safe and effective but is not without potential risks such as spontaneous bleeding in the abdominal cavity. There is limited evidence evaluating the true incidence of this potential risk and the available literature is primarily via case reports.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Case summary<\/jats:title>\n<jats:p>The purpose of this study was to identify the incidence and risk factors associated with enoxaparin use (prophylaxis or treatment) abdominal hematomas in a 350-bed community hospital during an 8-month time period. A total of 44 patients were identified as clinically significant bleeds receiving enoxaparin treatment or prophylactic therapy. Ultimately, 25 patients were excluded from the analysis due to an external cause of the abdominal hematoma or a temporal mismatch in enoxaparin administration and hematoma formation. After exclusion, there were a total of 19 patients that were assessed for the risk factors such as age, gender, renal function, and weight. After evaluation of risks, over half of the patients developing a clinically significant bleed were considered elderly (&gt;65 years of age) and impaired renal function with a creatinine clearance of 60ml\/min or less.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Patients at risk for an enoxaparin associated hematoma include female patients with a CrCl &lt;60ml\/min and\/or BMI &gt;30 kg\/m2 receiving enoxaparin treatment dosing.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0301906","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T18:09:03Z","timestamp":1713290943000},"page":"e0301906","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intra-abdominal hematomas and identifiable risk factors in patients receiving subcutaneous enoxaparin"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1460-3716","authenticated-orcid":true,"given":"Stephanie","family":"Lager","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gautam","family":"Balakrishnan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riley","family":"Eiberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"pone.0301906.ref001","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1056\/NEJM199909093411103","article-title":"A Comparison of Enoxaparin with Placebo for the Prevention of Venous Thromboembolism in Acutely Ill Medical Patients","volume":"341","year":"1999","journal-title":"N Engl J Med"},{"key":"pone.0301906.ref002","first-page":"89","article-title":"Efficacy and Bleeding Complications Among Patients Randomized to Enoxaparin or Unfractionated Heparin for Antithrombin Therapy in Non-ST-Segment Elevation Acute Coronary Syndromes","volume":"292","year":"2004","journal-title":"JAMA"},{"issue":"12","key":"pone.0301906.ref003","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1007\/s00134-001-1133-1","article-title":"Enoxaparin-Associated Severe Retroperitoneal Bleeding and Abdominal Compartment Syndrome: A Report of Two Cases","author":"Dabney","year":"2001","journal-title":"Intensive Care Med"},{"issue":"8","key":"pone.0301906.ref004","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.arth.2006.01.018","article-title":"Massive Retroperitoneal Hematoma During Enoxaparin Treatment of Pulmonary Embolism After Primary Total Hip Arthroplasty: case reports and review of the literature","author":"Lee","year":"2006","journal-title":"J of Arthroplasty"},{"issue":"10","key":"pone.0301906.ref005","doi-asserted-by":"crossref","first-page":"14","DOI":"10.5348\/ijcri-2011-10-60-CR-4","article-title":"Massive Spontaneous Retroperitoneal Hemorrhage Induced by Enoxaparin and Subsequent Abdominal Compartment Syndrome Requiring Surgical Decompression: A Case Report and Literature Review","volume":"2","author":"Quartey","year":"2001","journal-title":"IJCRI"},{"issue":"12","key":"pone.0301906.ref006","doi-asserted-by":"crossref","first-page":"1559e1","DOI":"10.1016\/j.ajem.2014.05.026","article-title":"Enoxaparin-Induced Spontaneous Massive Retroperitoneal Hematoma with Fatal Outcome","volume":"32","author":"Salemis","year":"2014","journal-title":"Am J of Emerg Med"},{"issue":"12","key":"pone.0301906.ref007","doi-asserted-by":"crossref","first-page":"3432","DOI":"10.1002\/ccr3.3427","article-title":"Rectus Sheath Hematoma in Patients Receiving Subcutaneous Enoxaparin: A Case Series of Five Patients","volume":"8","author":"Mendes","year":"2020","journal-title":"Clin Case Rep"},{"issue":"9","key":"pone.0301906.ref008","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1056\/NEJMoa2105911","article-title":"Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid 19","volume":"385","year":"2021","journal-title":"NEJM"},{"key":"pone.0301906.ref009","doi-asserted-by":"crossref","first-page":"e553","DOI":"10.1136\/bmj.e553","article-title":"Efficacy and safety of enoxaparin versus unfractionated heparin during percutaneous coronary intervention; systemic review and meta-analysis","volume":"344","year":"2012","journal-title":"BMJ"},{"issue":"2","key":"pone.0301906.ref010","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1001\/archinte.160.2.229","article-title":"Low-Molecular-Weight Heparin vs Heparin in the Treatment of Patients with Pulmonary Embolism. American Canadian Thrombosis Study Group","volume":"160","year":"2000","journal-title":"Arch Intern Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0301906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T18:09:12Z","timestamp":1713290952000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0301906"}},"subtitle":[],"editor":[{"given":"Gagandeep","family":"Dhillon","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0301906","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}