ICU sedation, delirium & recovery
Anti-Xa Levels With Venous Thromboembolism Prophylaxis in Critical Care: A Systematic Review and Meta-Analysis
Pooled resultResult — go to the resultuOR 2.87 95% CI 1.42–5.81Authors' conclusion
Less than half of critically ill patients achieved their prophylactic anti-Xa targets despite LMWH thromboprophylaxis. Subprophylactic anti-Xa levels may be associated with an increased risk of VTE. Male sex, increased weight, and elevated body mass index have a moderate certainty association with developing subprophylactic anti-Xa levels.
Study context
- Population
- Critically ill adults receiving LMWH thromboprophylaxis
- Participants
- 7,124 adults · 39 studies
- Comparison
- Subprophylactic vs target anti-Xa levels with LMWH thromboprophylaxis
- Outcome
- VTE risk and proportion achieving target anti-Xa levels
Methodological detailsGRADE certainty assessment, Cochrane risk of bias tools
- GRADE certainty assessment
- Cochrane risk of bias tools
Pooled result
As reported in the abstract
uOR
2.87
95% CI 1.42–5.81
- Proportion achieving target anti-Xa levels on LMWH prophylaxis
- 47% (95% CI, 36-57%)
Further pooled results
Predictors of subprophylactic anti-Xa levels
| aOR (95% CI) | ||
|---|---|---|
| Male sexModerate certainty | 2.65 (1.07–6.56) | |
| 0.10.31310Adjusted odds ratio (log scale) |
| Outcome | MD (kg) (95% CI) | |
|---|---|---|
| Predictors of subprophylactic anti-Xa levelsSubprophylactic anti-Xa vs Target anti-Xa · weight; moderate certainty | 4.90 (2.78–7.02) | |
| −50510Difference, kg (linear scale) |
| Outcome | MD (kg/m 2) (95% CI) | |
|---|---|---|
| Predictors of subprophylactic anti-Xa levelsSubprophylactic anti-Xa vs Target anti-Xa · BMI; moderate certainty | 1.36 (0.64–2.09) | |
| −10123Difference, kg/m 2 (linear scale) |
Original publication
Anti-Xa Levels With Venous Thromboembolism Prophylaxis in Critical Care: A Systematic Review and Meta-Analysis. Crit Care Med. Published 11 March 2026. doi:10.
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