Document Detail


Thromboprophylaxis after hip fracture: evaluation of 3 pharmacologic agents.
MedLine Citation:
PMID:  17461395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared the clinical efficacy and side-effect profiles of aspirin, dextran 40, and low-molecular-weight heparin (enoxaparin) in preventing thromboembolic phenomena after hip fracture surgery. All patients admitted with a diagnosis of hip fracture to our institution between July 1, 1987, and December 31, 1999, were evaluated. Study inclusion criteria were age 65 years or older, previously ambulatory, cognitively intact, home-dwelling, and having a nonpathologic intertrochanteric or femoral neck fracture. Each patient received mechanical thromboprophylaxis (above-knee elastic stockings) and 1 pharmacologic agent (aspirin, dextran 40, or enoxaparin); patients who received aspirin were also given a calf sequential compression device. Meeting the selection criteria and included in the study were 917 patients. Findings included low incidence of thromboembolic phenomena (deep vein thrombosis, 0.5%-1.7%; pulmonary embolism, 0%-2.0%; fatal pulmonary embolism, 0%-0.5%) and no difference among the 3 pharmacologic agents in thromboembolic prophylaxis efficacy. Use of enoxaparin was associated with a significant increase (3.8%) in wound hematoma compared with dextran 40 (1.6%) and aspirin (2.4%) (P<.01). The 3 agents were found not to differ with respect to mortality, thromboembolic phenomena, hemorrhagic complications, or wound complications.
Authors:
Gerard K Jeong; Konrad I Gruson; Kenneth A Egol; Gina B Aharonoff; Adam H Karp; Joseph D Zuckerman; Kenneth J Koval
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of orthopedics (Belle Mead, N.J.)     Volume:  36     ISSN:  1078-4519     ISO Abbreviation:  Am J. Orthop.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-04-27     Completed Date:  2007-05-29     Revised Date:  2010-01-05    
Medline Journal Info:
Nlm Unique ID:  9502918     Medline TA:  Am J Orthop (Belle Mead NJ)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  135-40     Citation Subset:  IM    
Affiliation:
New York University Hospital for Joint Diseases, New York, New York 10003, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anticoagulants / administration & dosage,  therapeutic use
Aspirin / administration & dosage,  therapeutic use*
Dextrans / administration & dosage,  therapeutic use*
Enoxaparin / administration & dosage,  therapeutic use*
Female
Fibrinolytic Agents / administration & dosage,  therapeutic use
Follow-Up Studies
Hip Fractures / complications*
Humans
Incidence
Male
Pulmonary Embolism / epidemiology,  etiology,  prevention & control*
Retrospective Studies
Survival Rate
Treatment Outcome
Venous Thrombosis / epidemiology,  etiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 0/Fibrinolytic Agents; 50-78-2/Aspirin; 9004-54-0/Dextrans

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