Document Detail


Prevention of fatal pulmonary embolism in patients with fractures of the neck of the femur.
MedLine Citation:
PMID:  2409613     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with fractures of the neck of the femur have an extremely high incidence of venous thrombosis and pulmonary emboli, if not receiving prevention with drugs. From a prospective, randomized multicenter trial comparing the effectiveness of two methods for the prevention of postoperative fatal pulmonary emboli, we analyzed those patients having been operated upon for a fracture of the neck of the femur. One hundred and seventy-two patients having had heparin-DHE prevention and 157 having had dextran prevention are compared with 150 patients in the control group and 165 patients who were given phenindione for anticoagulation orally. The data from the latter two groups stem from a study done in 1959 by Sevitt and Gallagher which for the first time established the value of oral anticoagulation for reducing pulmonary emboli. All three prophylactic methods reduce the incidence of pulmonary emboli to the same degree. The mortality associated with pulmonary emboli is 2 per cent in the phenindione group, 2.3 per cent in the heparin-DHE group and 3.8 per cent in the dextran group, in contrast with 10 per cent in the control group. Total mortality has been lowered significantly in all three groups as compared with the control group. Fatal pulmonary emboli were found only when prophylaxis had been stopped or was incomplete and were not found when prophylactic regimen was done properly. In 1980, the hospital stay was about one week shorter than in 1959.
Authors:
U F Gruber
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Surgery, gynecology & obstetrics     Volume:  161     ISSN:  0039-6087     ISO Abbreviation:  Surg Gynecol Obstet     Publication Date:  1985 Jul 
Date Detail:
Created Date:  1985-08-09     Completed Date:  1985-08-09     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0101370     Medline TA:  Surg Gynecol Obstet     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  37-42     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Dextrans / therapeutic use*
Dihydroergotamine / adverse effects,  therapeutic use*
Drug Combinations / adverse effects,  therapeutic use
Female
Femoral Neck Fractures / complications*,  surgery
Heparin / adverse effects,  therapeutic use*
Heparin, Low-Molecular-Weight*
Humans
Length of Stay
Male
Middle Aged
Phenindione / therapeutic use*
Pulmonary Embolism / etiology,  mortality,  prevention & control*
Chemical
Reg. No./Substance:
0/Drug Combinations; 0/Heparin, Low-Molecular-Weight; 0/heparin-dihydergot; 511-12-6/Dihydroergotamine; 83-12-5/Phenindione; 9004-54-0/Dextrans; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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