Open Access
Duration of Prophylaxis Against Venous Thromboembolism With Fondaparinux After Hip Fracture Surgery
Reads0
Chats0
TLDR
In this paper, a double-blind multicenter trial, 656 patients undergoing hip fracture surgery were randomly assigned to receive prophylaxis with a once-daily subcutaneous injection of either 2.5 mg of fondaparinux sodium or placebo for 19 to 23 days.Abstract:Â
Background: The benefit of thromboprophylaxis for 1 month has never been evaluated in patients undergoing hip fracture surgery, a setting in the highest risk category for postoperative venous thromboembolism (VTE). Methods: In a double-blind multicenter trial, 656 patients undergoing hip fracture surgery were randomly assigned to receive prophylaxis with a once-daily subcutaneous injection of either 2.5 mg of fondaparinux sodium or placebo for 19 to 23 days. Before randomization, all patients had received fondaparinux for 6 to 8 days. The primary efficacy outcome was VTE occurring during the double-blind period (deep vein thrombosis detected by mandatory bilateral venography or documented symptomatic deep vein thrombosis or pulmonary embolism). The main safety outcome was major bleeding. Results: The primary efficacy outcome was assessed in 428 patients. Fondaparinux reduced the incidence of VTE compared with placebo from 35.0% (77/220) to 1.4% (3/208), with a relative reduction in risk of 95.9% (95% confidence interval, 87.2%-99.7%; P.001). Similarly, the incidence of symptomatic VTE was significantly lower with fondaparinux (1/326; 0.3%) than with placebo (9/330; 2.7%). The relative reduction in risk was 88.8% (P=.02). Although there was a trend toward more major bleeding in the fondaparinux group than in the placebo group (P=.06), there were no differences between the 2 groups in the incidence of clinically relevant bleeding (leading to death, reoperation, or critical organ bleeding). Conclusions: Extended prophylaxis with fondaparinux for 3 weeks after hip fracture surgery reduced the risk of VTE by 96% and was well tolerated. Arch Intern Med. 2003;163:1337-1342read more
Citations
More filters
Journal ArticleDOI
Prevention of Venous Thromboembolism* American College of Chest Physicians Evidence- Based Clinical Practice Guidelines (8th Edition)
William H. Geerts,David Bergqvist,Graham F. Pineo,John A. Heit,Charles M. Samama,Michael R. Lassen,Clifford W. Colwell +6 more
TL;DR: This article discusses the prevention of venous thromboembolism (VTE) and is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).
Journal ArticleDOI
Prevention of Venous Thromboembolism : The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
William H. Geerts,Graham F. Pineo,John A. Heit,David Bergqvist,Michael R. Lassen,Clifford W. Colwell,Joel G. Ray +6 more
TL;DR: This article discusses the prevention of venous thromboembolism (VTE) and is part of the Seventh American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines.
Journal ArticleDOI
Prevention of VTE in Nonsurgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Yngve Falck-Ytter,Charles W. Francis,Norman A. Johanson,Catherine Curley,Ola E. Dahl,Sam Schulman,Thomas L. Ortel,Stephen G. Pauker,Clifford W. Colwell +8 more
TL;DR: In this article, the authors focus on optimal prophylaxis to reduce postoperative pulmonary embolism and DVT following major orthopedic surgery, and suggest the use of low-molecular-weight heparin in preference to the other agents we have recommended as alternatives.
Journal ArticleDOI
Prevention of VTE in Orthopedic Surgery Patients
Yngve Falck-Ytter,Charles W. Francis,Norman A. Johanson,Catherine Curley,Ola E. Dahl,Sam Schulman,Thomas L. Ortel,Stephen G. Pauker,Clifford W. Colwell +8 more
TL;DR: Optimal strategies for thromboprophylaxis after major orthopedic surgery include pharmacologic and mechanical approaches.
Journal ArticleDOI
Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial
Bengt I. Eriksson,Ola E. Dahl,Nadia Rosencher,Andreas A. Kurth,C Niek van Dijk,Simon P. Frostick,Martin H. Prins,Rohan Hettiarachchi,Stefan Hantel,Janet Schnee,Harry R. Büller +10 more
TL;DR: Oral dabigatran etexilate was as effective as enoxaparin in reducing the risk of venous thromboembolism after total hip replacement surgery, with a similar safety profile.
References
More filters
Journal ArticleDOI
Prevention of venous thromboembolism
Willitim Geerts,Joel C. Ray,Clifford W. Colwell,David Bergqvist,Graham F. Pineo,M. R. Lassen,John A. Heit +6 more
TL;DR: The risk factors for VTE among hospitalized patients are outlined, the efficacy and safety of alternative prophylaxis regimens are reviewed, and recommendations regarding the most suitable prophymic regimens based on the estimated risk are provided.
Journal ArticleDOI
Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED).
TL;DR: Follow-up and angiography together suggest pulmonary embolism occurred among 12% of patients with low-probability scans, and clinical assessment combined with the ventilation/perfusion scan established the diagnosis or exclusion of pulmonary emblism only for a minority of patients--those with clear and concordant clinical and ventilation-perfusions scan findings.
Journal ArticleDOI
Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial
Jeremy L. O'Brien,H Duncan,George Kirsh,V Allen,P King,R Hargraves,L. Mendes,T Perera,P Catto,Steven R. Schofield,H Ploschke,T Hefner,M Churchland,S Woolnough,R Wuttke,Maurice Manning,T Jeffries,L Hensley,Philip M.W. Bath,D Bainbridge,F Guinane,L McMahon,D Zavattaro,David Wilson,K Blake,J Morton,D Sharman,R Locke,J Ghabrial,S McNeil,P Rehfisch,S van der Merwe,B Einoder,D. Douglas,J Ashwell,A Morrissey,Alex Brown,R Simm,G Fisch,W Crawford,T Everding,D Tanham,J Hooper,C Aldana,M Goldwasser,M Mibus,Neville Rowden,J Mills,P Johnson,J Stilwell,Richard S. Williams,T Stevenson,J Zwar,R Bauze,B Nyunt,R Russell,G Day,M Cameron,P Clements,Thomas J. Beck,A Ellis,S Phipps,W Quaill,A Skirving,M McGuiness,P Gray,J Rankin,David A. Wood,J.,B Courtenay,Martin S. Green,Ian A. Harris,J Rush,M Kilgour,J Davies,J Newcombe,C Lewis,S Leitl,R Chilcott,R Pianta,A Aguila,C Hawe,S Nade,Mari Smith,P Robertson,A Rothwell,S May,Steven Williams,S Shamy,G Martin,V Steele,Kathryn J. Jeffery,I Kelman,J McKillan,P Dayaram,J Culling,D Lawson,P Winfield,R Kuzel,C Milburn,N Palmer,A Pitts,G Lamb,L Prodan,Harley Gray,K Walker,Kenneth Smith,Charles R. Newton,D Atkinson,B Fail,A Panting,J Menzies,A Watkiss,J Outhred,D Clay,R Lander,R Fou,D S Clarke,T Murrell,B Rolleston,S Keyworth,P Medlicott,T Woods,C Dawe,R Waldron,W Taine,L Le Roy,Andrew Smith,G Cowley,Colin A. Campbell,R Maxwell,M Elvy,Allen Thurston,S Newth,L Cousins,M Sanderson,C MacMillan,R Golele,J Walters,S Kruger,T Ramsden,H Joseph,D Gantz,S Steyn,S Hadjichristofis,L Nojoko,R Snowdowne,M Botha,R Knebel,I Sernbo,B Ferris,E Tello,A Nevelos,C Dunn,D Warwick,J Sudhakar,J D Tuite,Jobbin Francis,M E Wallace,A Jordan,P Baird,W Fowler,Ainscow Dap.,A Harrison,A Butler-Manuel,G Broome,P Swailes,T J Stahl,A M Randall,A J Forester,J Hucker,J Redden,L Logan,P W Howard,D Brownlee,P Angus,A Boyce,B B Porter,M Arbid,J Youll,A S Ogden,C MacDowell,M Beverly,P Ramdeholl,I Nelson,I Howlett,A Weeber,A Peacock,Hubbard Mjs.,M Flanagan,C Crawshaw,A Kinninmonth,T. Campbell,S Tibrewal,Lennox Cme.,I Clifford,N Gillham,M Hunt,C Bulstrode,R Handley,Vishwanath R. Iyer,J Lawton,J Robbins,W M Harper,J Davison,P Hope,K Smallbones,W. C. Jones,K R Ratnam,J Upton,P Hirst,S Knox,T Sadique,Mohammad Saud Khan,M Umar,Joshua T. Anderson,J Frank,Peter J. Briggs,P Sanderson,D McBride,K Leese,N C Bayliss,M El-Deen,H Banan,Michael Parker,H Minhas,A Best,C Blakeway,T Salter,M A Foy,A Pollitt,Blayney Jdm.,Stephen M. Davis,E Parnell,C Ko,M L Grover,S Howells,David J. Williams,C Saunders,I Brenkel,G Mani,M Grizzle,A Henderson,T Board,C J Chadwick,M Overton,S Hodkinson,D A Macdonald,V Lewis,McDonald Rjm.,J Adamson,J Bradley,E Hodgson,J L Plewes,D Clarke,M Hullin,Jason M. Smith,G J Lemon,K Greatrex,C Miles,G Bannister,J Dare,D G Carden,J Aughton,A Stirrat,J Fishburn,A O Ebizie,M Mason,G Irvine,T Facey,C Spratt,N Kanagavel,T Gerrard,N Reissis,P Tzanetos,M Stefanotti,M Greiss,V Wright,A Rahmaty,John Archer,A Bedford,David Taylor,M Griffith,Jennifer R Evans,K Heron,B Livingstone,K O'Dwyer,David J. Wheatley,P Campbell,P Dixon,L McSweeney,Shanahan Mdg.,I Griffith,Stephen MacMahon,Anthony Rodgers,Rory Collins,C Prentice,Robyn Norton,P Ockleford,M Rutland,J Dickinson,P Gregg,D Macdonald,Mollan Rab.,J. Douglas,D Beaumont,Joanna Broad,Taane G. Clark,M. A. Henderson,A McCulloch,Bruce Neal,Rajendra Prasad,Natalie Walker,M Wood,A Beighton,P Bell,Barbara Farrell,K Murch,Norman Sharpe,Gary Gordon,Robert N. Doughty,Yogini Ratnasabapathy,John Danesh,Peter Sleight,Richard Peto,John Simes,Anthony C Keech,Tri Pep. +327 more
TL;DR: In this article, a meta-analysis of their results indicated reductions in the risks of deep-vein thrombosis and of pulmonary embolism in various high-risk groups.
Journal ArticleDOI
Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer.
David Bergqvist,Giancarlo Agnelli,Alexander T. Cohen,Amiram Eldor,Paul E. Nilsson,A Le Moigne-Amrani,F Dietrich-Neto +6 more
TL;DR: Enoxaparin prophylaxis for four weeks after surgery for abdominal or pelvic cancer is safe and significantly reduces the incidence of venographically demonstrated thrombosis, as compared with enoxapin prophyllaxis for one week.
Journal ArticleDOI
Roentgen diagnosis of venous thrombosis in the leg
Keith Rabinov,Sven Paulin +1 more
TL;DR: In technique for lower extremity phlebography the patient is in a semi-upright position, supporting his weight on the contralateral foot, and the dye injection is made into a dorsal pedal vein and no tourniquet is used.