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July 1, 1999Journal of Bone and Joint Surgery

Comparison of Enoxaparin and Warfarin for the Prevention of Venous Thromboembolic Disease After Total Hip Arthroplasty. Evaluation During Hospitalization and Three Months After Discharge*

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Why the study?

Does enoxaparin reduce clinically important venous thromboembolic disease compared to warfarin in patients after total hip arthroplasty?

Population

3,011 patients undergoing total hip arthroplasty at 156 centers

Comparison

Enoxaparin injection during hospitalization vs Adjusted-dose warfarin oral administration…

Design

RCT, Randomly assigned

Follow-up

Three months after discharge

Authors

CCClifford W. ColwellScripps ClinicDCDennis K. CollisOrthopedic CenterRPRolf PaulsonJohns Hopkins University

Discussion

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Implication

Enoxaparin may be preferred for in-hospital VTE prophylaxis after THA; confirms short-term superiority over warfarin but leaves open optimal duration.

Structured PICO

Does enoxaparin reduce clinically important venous thromboembolic disease compared to warfarin in patients after total hip arthroplasty?

P
Population
3,011 patients undergoing total hip arthroplasty at 156 centers
I
Intervention
Enoxaparin injection (30 mg every 12 hours) during hospitalization (mean 7.3 days)
C
Comparator
Adjusted-dose warfarin oral administration during hospitalization
O
Outcome
Clinically important venous thromboembolic disease (distal or proximal deep venous thrombosis or pulmonary embolism, or both) during hospitalizationcomposite

Enoxaparin provides superior protection against venous thromboembolic disease compared to warfarin during hospitalization after total hip arthroplasty, but this benefit is lost after discontinuation of the medication.

Cite This Study

Colwell et al. (1999) studied this question.

synapsesocial.com/papers/6a1bc53ab33628da419cd496https://doi.org/10.2106/00004623-199907000-00005

Topics

Pulmonary embolismAnticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Venous Thromboembolic Disease After Hip Surgery1989 · 103 citations
  2. 2Femoral vein thrombosis and total hip replacement.1977 · 235 citations
  3. 3Use of enoxaparin, a low-molecular-weight heparin, and unfractionated heparin for the prevention of deep venous thrombosis after elective hip replacement. A clinical trial comparing efficacy and safety. Enoxaparin Clinical Trial Group.1994 · 221 citations
  4. 4Low molecular weight heparin1992 · 676 citations
  5. 5Low-Molecular-Weight Heparin (Enoxaparin) as Prophylaxis against Venous Thromboembolism after Total Hip Replacement1996 · 461 citations