Weight-based, anti-Xa guided enoxaparin after spine trauma surgery: target attainment and safety in a retrospective cohort - Summary - MDSpire

Weight-based, anti-Xa guided enoxaparin after spine trauma surgery: target attainment and safety in a retrospective cohort

  • By

  • Dallas L. Sheinberg

  • David Travis Johnston

  • Brendan T. O'Reilly

  • Gabriel Galan Castro

  • Jawad R. Khazaal

  • Joseph S. Withrow

  • Duncan J. Trimble

  • Ankush Chandra

  • Anthony J. Lim

  • Derek S. Sheinberg

  • Jennifer Zaragoza

  • Wen Li

  • John R. Williams

  • June 24, 2026

  • 0 min

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Objective:

To evaluate anti-Xa target attainment, symptomatic VTE, and safety outcomes after anti-Xa-guided enoxaparin titration in postoperative spine trauma patients.

Approach:
  • Comparison: A comparison cohort received the same initial dosing without anti-Xa monitoring, allowing for a direct comparison of outcomes.
Key Findings:
  • Symptomatic VTE was rare and similar between anti-Xa and fixed dose groups (1.1% vs. 1.6%).
  • No postoperative epidural hematomas occurred.
  • 28% of the anti-Xa cohort required dose escalation, with 7% needing more than one adjustment.
  • Bleeding requiring transfusion and length of stay did not differ between groups.
Interpretation:

Weight-based enoxaparin with anti-Xa-guided titration was feasible and identified patients below the prophylactic anti-Xa target range without increasing bleeding risks.

Limitations:
  • Retrospective design may introduce bias.
  • Findings are based on a single trauma center, limiting generalizability.
Conclusion:

Further research is necessary to explore the relationship between anti-Xa target attainment and VTE rates.

Original Source(s)

Weight-based, anti-Xa guided enoxaparin after spine trauma surgery: target attainment and safety in a retrospective cohort

  • by Dallas L. Sheinberg, David Travis Johnston, Brendan T. O'Reilly, Gabriel Galan Castro, Jawad R. Khazaal, Joseph S. Withrow, Duncan J. Trimble, Ankush Chandra, Anthony J. Lim, Derek S. Sheinberg, Jennifer Zaragoza, Wen Li, John R. Williams

  • June 24, 2026

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