1997
DOI: 10.2106/00004623-199709000-00011
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Prevention of Deep-Vein Thrombosis after Total Hip Arthroplasty

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Cited by 160 publications
(117 citation statements)
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“…Some researchers use a decrease in hemoglobin greater than 2 g/dL in the definition of major bleeding [11], and the rate of major bleeding frequently is reported as a safety outcome in trials of thromboprophylaxis [9,13,16,23]. We found such a decrease in hemoglobin for the majority of patients until the first postoperative injection (83% versus 90%) and the day after surgery (93% versus 90%), which indicates a decrease in hemoglobin is a poor parameter for defining major bleeding in patients undergoing THA.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Some researchers use a decrease in hemoglobin greater than 2 g/dL in the definition of major bleeding [11], and the rate of major bleeding frequently is reported as a safety outcome in trials of thromboprophylaxis [9,13,16,23]. We found such a decrease in hemoglobin for the majority of patients until the first postoperative injection (83% versus 90%) and the day after surgery (93% versus 90%), which indicates a decrease in hemoglobin is a poor parameter for defining major bleeding in patients undergoing THA.…”
Section: Discussionmentioning
confidence: 99%
“…Type of antithrombotic drug, dosage, and timing of the first dose may influence bleeding and development of thrombosis. Low-molecular-weight heparins (LMWHs) are widely used antithrombotics because of their favorable efficacy-to-safety profiles [9,23], but the best timing of the first dose remains controversial [24,28]. Preoperative initiation 12 hours before surgery has been based on the premise that DVT starts during surgery and that preoperative initiation is necessary to optimize antithrombotic effectiveness [17,27].…”
Section: Introductionmentioning
confidence: 99%
“…Bleeding is more common with Group A anticoagulants. Bleeding [5,8,17,18,23,26,41,42,52,55,61] can lead to death from multiple causes, including shock, renal failure, stroke, myocardial infarction, infection, and sepsis. It is likely complications of bleeding contributed to the increased mortality.…”
Section: Discussionmentioning
confidence: 99%
“…Thromboprophylaxis in close proximity to hip arthroplasty, either preoperatively or postoperatively, may balance efficacy and safety to prevent thrombosis on one hand and bleeding on the other hand. Clinical observations indicated that LMWH at half the usual high-risk dose begun in close proximity to THA either preoperatively or postoperatively [39,40] was more effective than LMWH administered 12 hours preoperatively or 12-18 hours postoperatively [17,19]. However, administration less than 2 hours before surgery resulted in increased major bleeding, while a postoperative regimen of LMWH 4-6 hours after surgery provided efficacy without significantly increasing bleeding [40].…”
Section: Discussionmentioning
confidence: 99%