Document Detail


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.
MedLine Citation:
PMID:  9212355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A J Palmer; K Koppenhagen; B Kirchhof; U Weber; R Bergemann
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Haemostasis     Volume:  27     ISSN:  0301-0147     ISO Abbreviation:  Haemostasis     Publication Date:    1997 Mar-Apr
Date Detail:
Created Date:  1997-09-02     Completed Date:  1997-09-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0371574     Medline TA:  Haemostasis     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  75-84     Citation Subset:  IM    
Affiliation:
Institute for Medical Informatics and Biostatistics, Riehen, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / 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:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight; 81-81-2/Warfarin; 9005-49-6/Heparin

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