Medication Use Evaluation for Enoxaparin in Hospitalized COVID-19 Patients
- Conditions
- Venous Thromboembolism
- Registration Number
- NCT05226793
- Lead Sponsor
- Methodist Health System
- Brief Summary
Retrospective chart review to be conducted at Methodist Richardson Medical Center (MRMC) in Richardson, TX. All adult patients hospitalized with COVID-19 on enoxaparin for DVT prophylaxis will be included. Collected data will be analyzed to determine the safety and effectiveness of the varying enoxaparin doses, and results will be presented at the American Society of Health-System Pharmacists Midyear conference in December 2022.
- Detailed Description
Retrospective chart review to be conducted at Methodist Richardson Medical Center (MRMC) in Richardson, TX. All adult patients hospitalized with COVID-19 on enoxaparin for DVT prophylaxis will be included. Collected data will be analyzed to determine the safety and effectiveness of the varying enoxaparin doses, and results will be presented at the American Society of Health-System Pharmacists Midyear conference in December 2022.
EPIC will be queried for data for this medication use evaluation, including the patient's age, sex, weight/BMI, ICU status, maximum D-dimer level, enoxaparin dose received, development of DVT or PE, incidence and type of bleeding events, readmission status, and mortality. Other patient specific factors such as the CCI score, Padua score, and IMPROVE score will be calculated using online risk assessment tools.
To calculate the CCI score, a search function will be used to analyze the patient's health information in order to determine their age, history of myocardial infarction, congestive heart failure, peripheral vascular disease, stroke or transient ischemic attack, dementia, chronic obstructive pulmonary disease, connective tissue disease, peptic ulcer disease, liver disease, diabetes mellitus, kidney function, cancer status, blood dyscrasias, and HIV status to estimate their 10-year probability of survival.
To calculate the Padua score, each patient must be evaluated for cancer status, history of VTE, mobility status, history of thrombophilic conditions, recent trauma or surgery, age, heart and/or respiratory failure, acute myocardial infarction and/or respiratory failure status, acute infection and/or rheumatologic disorder, obesity, and ongoing hormonal treatment. If a patient scores a 4 or more, then pharmacologic prophylaxis would be indicated.
Lastly, to calculate each patient's bleeding risk, the IMPROVE bleeding risk assessment will be used. For this tool, the patient's age, gender, renal function, liver function, platelet count, ICU status, the presence of a central venous catheter, active gastrointestinal ulcer, history of bleeding in the previous three months, presence of rheumatic disease, and active malignancy are needed to calculate the risk. If the patient scores a 7 or higher on the assessment, they are at an increased risk for bleeding.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 400
Effectiveness of intermediate-intensity vs standard prophylactic enoxaparin regimens on preventing DVT and/or PE in patients with COVID-19, measured using the following variables:
- Enoxaparin dose (appropriate for kidney function)
- Charlson comorbidity index (CCI) score
- Padua prediction score for risk of VTE
- IMPROVE [International Medical Prevention Registry on VTE] bleeding risk assessment score
- ICU status
- Number of thromboembolic events
- Length of stay
- Readmissions for DVT and/or PE
- In-hospital mortality with associated DVT or PE
-
Safety of intermediate-intensity vs standard prophylactic enoxaparin regimens in patients with COVID-19, measured using the following variables:
- Bleeding events
- Type of bleeding event
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Charlson comorbidity index (CCI) score 2021-2022 (CCI) score
ICU status 2021-2022 ICU status
Number of thromboembolic events 2021-2022 Number of thromboembolic events
Length of stay 2021-2022 Days
Padua prediction score for risk of VTE 2021-2022 Padua prediction score
Enoxaparin dose (appropriate for kidney function) 2021-2022 Enoxaparin dose
Readmissions for DVT and/or PE 2021-2022 Readmissions for DVT and/or PE
IMPROVE [International Medical Prevention Registry on VTE] bleeding risk assessment score 2021-2022 IMPROVE \[International Medical Prevention Registry on VTE\] bleeding risk assessment score
In-hospital mortality with associated DVT or PE 2021-2022 In-hospital mortality with associated DVT or PE
- Secondary Outcome Measures
Name Time Method Bleeding events 2021-2022 Bleeding events
Type of bleeding event 2021-2022 Type of bleeding event
Trial Locations
- Locations (1)
Methodist Richardson Medical Center
🇺🇸Richardson, Texas, United States