| Efficacy and safety of low molecular weight heparin, unfractionated heparin and warfarin for thrombo-embolism prophylaxis in orthopaedic surgery: a meta-analysis of randomised clinical trials. | |
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MedLine Citation:
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PMID: 9212355 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The efficacy and safety of low molecular weight heparin (LMWH), unfractionated heparin (UFH) and warfarin for prophylaxis of thrombo-embolism in orthopaedic surgery were compared using meta-analysis techniques. Twenty-two studies were included, 2 of which compared LMWH to warfarin. The mean probabilities to develop deep-vein thrombosis (DVT), pulmonary embolism and major and minor bleeding using UFH were: 0.21 (95% confidence interval, CI: 0.18-0.24); 0.01 (95% CI: 0.01-0.02); 0.05 (95% CI: 0.03-0.07), and 0.19 (95% CI: 0.17-0.22), respectively. The relative risk (RR) of DVT for LMWH vs. UFH was 0.76 (95% CI: 0.60-0.91), p < 0.05 and for LMWH vs. warfarin 0.78 (95% CI: 0.69-0.87), p < 0.05. The RR of minor bleeding for LMWH vs. UFH was 0.76 (95% CI: 0.64-0.92), p < 0.05. The RR of minor bleeding for LMWH vs. warfarin was 3.28 (95% CI: 2.21-4.70), p < 0.05. Conclusion: in orthopaedic surgery, LMWH is significantly superior to both UFH and warfarin in the prevention of DVT and results in significantly less minor bleeding complications when compared to UFH, but significantly more minor bleeding when compared to warfarin. |
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Authors:
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A J Palmer; K Koppenhagen; B Kirchhof; U Weber; R Bergemann |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Haemostasis Volume: 27 ISSN: 0301-0147 ISO Abbreviation: Haemostasis Publication Date: 1997 Mar-Apr |
Date Detail:
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Created Date: 1997-09-02 Completed Date: 1997-09-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0371574 Medline TA: Haemostasis Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 75-84 Citation Subset: IM |
Affiliation:
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Institute for Medical Informatics and Biostatistics, Riehen, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anticoagulants
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adverse effects,
therapeutic use* Hemorrhage / chemically induced Heparin / adverse effects, therapeutic use* Heparin, Low-Molecular-Weight / adverse effects, therapeutic use* Humans Orthopedics* Postoperative Complications / prevention & control* Randomized Controlled Trials as Topic Thromboembolism / prevention & control* Warfarin / adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Heparin, Low-Molecular-Weight; 81-81-2/Warfarin; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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