Prevention of deep-vein thrombosis and pulmonary embolism after total hip replacement. Comparison of low-molecular-weight heparin and unfractionated heparin.

Early postoperative mortality after 67,548 total hip replacements

“…The causes of this increase and its duration are not clear. The prevention of deep venous thrombosis by thromboprophylaxis after hip surgery has been studied in several randomized clinical trials (Eriksson et al 1991, Borris et al 1994, Imperiale and Speroff 1994, Bergqvist et al 1996, Planes et al 1996, Comp et al 1998, Colwell et al 1999). The essential relationship between thromboprophylaxis and mortality in hip replacement surgery is still debated (Seagrott et al 1991, Murray et al1996, Bulstrode 1998, Salvati et al 2000, Thomas 2000 although the relationship between heparin thromboprophylaxis and lower overall mortality and lower mortality due to pulmonary embolism in major surgery, including total hip replacement, were found 25 years ago (Kakkar et al 1975, Collins et al 1988.…”

“…This study, however, gives good baseline estimates on mortality for other studies. Since the incidence of venous thrombosis after a THRoperation is high (10-80%) (Mohr et al 1993, Dahl et al 1997, Bulstrode 1998, it is a suitable outcome variable for randomized trials evaluating thrombo prophylaxis (Eriksson et al 1991, Borris et al 1994, Imperiale and Speroff 1994, Bergqvist et al 1996, Planes et al 1996, Comp et al 1998, Colwell et al 1999, Freedman et al 2000, Prentice 2000. In contrast, mortality after total hip replacement operations is low.…”

Drug prophylaxis of deep vein thrombosis in traumatology: is there a benefit of a score in outpatients?

“…There was a 4% incidence of DVT in group A although these patients received drug prophylaxis [11]. In comparison with the literature reporting an incidence of 10% DVT in outpatients, these results are encouraging [1,3,5,11] ( Table 5). The incidence of DVT in group B was 0.6% (n=2), and neither of these patients had followed the directions given to patients.…”

Aspects on Prophylaxis of Thromboembolism in Surgery

“…Although some differences exist between them, the overall conclusion is that the LMWHs are more suitable to prevent DVT than UFH, especially in orthopedic surgery. The effect seems to be relatively better regarding proximal DVT [21][22][23][24], and at least asymptomatic scinti- Aspects on Prophylaxis of Thromboembolism in Surgery 9 graphic pulmonary perfusion defects are decreased in frequency [22]. Table 3 summarizes data from several sources on FPE, and it can be seen that the lowest frequencies are obtained with LMWH.…”