Enoxaparin may be associated with lower rates of mortality than unfractionated heparin in neurocritical and surgical patients.Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are often administered to prevent venous thromboembolism (VTE) in critically ill patients.  However, the preferred prophylactic agent (UFH or LMWH) is not known.  We compared the all-cause mortality rate in patients receiving UFH to LMWH for VTE prophylaxis.  Initially 2228 patients in the cohort were included for analysis, 1836 (82%) patients received UFH, and 392 (18%) patients received enoxaparin.  After propensity score matching, a well-balanced cohort of 618 patients remained in the study (309 patients receiving UFH; 309 patients receiving enoxaparin).  The use of UFH for VTE prophylaxis in ICU patients was associated with similar rates of all-cause mortality compared with enoxaparin [RR 0.73; 95% CI 0.43-1.24, p = 0.310].  The use of UFH for VTE prophylaxis in ICU patients was associated with similar rates of VTE, all-cause mortality and LOS compared to enoxaparin.  In subgroup analysis, neuro-critical and surgical patients who received UFH had a higher rate of mortality than those who received enoxaparin.
UFH
Enoxaparin may be associated with lower rates of mortality than unfractionated heparin in neurocritical and surgical patients.Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are often administered to prevent venous thromboembolism (VTE) in critically ill patients.  However, the preferred prophylactic agent (UFH or LMWH) is not known.  We compared the all-cause mortality rate in patients receiving UFH to LMWH for VTE prophylaxis. 
LMWH
Patients were included if they were screened with venous duplex ultrasonography or computed tomography angiography for detection of VTE. 
venous duplex ultrasonography
Patients were included if they were screened with venous duplex ultrasonography or computed tomography angiography for detection of VTE. 
computed tomography angiography
Enoxaparin may be associated with lower rates of mortality than unfractionated heparin in neurocritical and surgical patients.Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are often administered to prevent venous thromboembolism (VTE) in critically ill patients.  Initially 2228 patients in the cohort were included for analysis, 1836 (82%) patients received UFH, and 392 (18%) patients received enoxaparin.  After propensity score matching, a well-balanced cohort of 618 patients remained in the study (309 patients receiving UFH; 309 patients receiving enoxaparin).  The use of UFH for VTE prophylaxis in ICU patients was associated with similar rates of all-cause mortality compared with enoxaparin [RR 0.73; 95% CI 0.43-1.24, p = 0.310].  A trend toward mortality benefit was observed in NICU [RR 0.37; 95% CI 0.13-1.07, p = 0.062] and surgical patients [RR 0.43; 95% CI 0.17-1.02, p = 0.075] favoring the enoxaparin group.  The use of UFH for VTE prophylaxis in ICU patients was associated with similar rates of VTE, all-cause mortality and LOS compared to enoxaparin.  In subgroup analysis, neuro-critical and surgical patients who received UFH had a higher rate of mortality than those who received enoxaparin.
enoxaparin