Venous thromboembolism clinically detected after hip fracture surgery with prophylaxis in a clinical practice setting

Am J Orthop (Belle Mead NJ). 2008 Sep;37(9):470-5.

Abstract

Clinical trials have shown differences in efficacy among anticoagulants used for venous thromboembolism (VTE) prophylaxis after hip fracture surgery, but the applicability of their results is limited by constraints of the clinical trial setting. We conducted this retrospective cohort study to assess VTE after hip fracture surgery in patients who received prophylaxis with dalteparin, enoxaparin, fondaparinux, or unfractionated heparin in a hospital setting. After adjustments were made for demographic differences, risk for VTE was significantly higher for dalteparin (odds ratio [OR], 1.4; 95% confidence interval [CI], 0.99-1.92), enoxaparin (OR, 1.4; 95% CI, 1.05-1.86), and unfractionated heparin (OR, 1.9; 95% CI, 1.39-2.58) compared with fondaparinux. These findings confirm the results of clinical trials in a real-world setting.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Anticoagulants / therapeutic use*
  • Cohort Studies
  • Dalteparin / therapeutic use
  • Enoxaparin / therapeutic use
  • Female
  • Follow-Up Studies
  • Fondaparinux
  • Fracture Fixation, Intramedullary / adverse effects*
  • Fracture Fixation, Intramedullary / methods
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / surgery*
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Odds Ratio
  • Polysaccharides / therapeutic use
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Premedication / methods*
  • Probability
  • Radiography
  • Retrospective Studies
  • Risk Assessment
  • Treatment Failure
  • Treatment Outcome
  • Venous Thromboembolism / epidemiology
  • Venous Thromboembolism / prevention & control*

Substances

  • Anticoagulants
  • Enoxaparin
  • Heparin, Low-Molecular-Weight
  • Polysaccharides
  • Fondaparinux
  • Dalteparin