What does this research mean for the field?

In patients receiving once-daily enoxaparine for DVT prophylaxis after hip replacement, maintaining 12-hour anti-factor Xa levels between 0.05 and 0.2 units per ml optimizes the balance between preventing thrombosis and minimizing bleeding risk. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the relationship between ex vivo anti-factor Xa levels and clinical outcomes, specifically wound hematoma and deep vein thrombosis, in patients receiving enoxaparin after total hip replacement.

January 1, 1989Thrombosis and Haemostasis

The Relationship between Anti-Factor Xa Level and Clinical Outcome in Patients Receiving Enoxaparine Low Molecular Weight Heparin to Prevent Deep Vein Thrombosis after Hip Replacement

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Why the study?

Does the anti-factor Xa level correlate with the risk of wound hematoma and postoperative thrombosis in patients receiving enoxaparin for DVT prophylaxis after hip replacement?

Population

163 patients undergoing total hip replacement

Design

Cohort

Follow-up

6 days postoperatively

Authors

MLMark N. LevineMedical Council of Canada APA. PlanèsAcciona (Spain)JHJ. HirshASTER

Discussion

Member takes

Implication

May support anti-factor Xa monitoring after hip replacement; hypothesis-generating and requires randomized confirmation before practice change.

Key Points

To evaluate the relationship between ex vivo anti-factor Xa levels and clinical outcomes, specifically wound hematoma and deep vein thrombosis, in patients receiving enoxaparin after total hip replacement.
Studied 163 patients undergoing total hip replacement receiving once-daily subcutaneous enoxaparin at either 40 mg (N=113) or 60 mg (N=50).
Collected blood samples to measure anti-factor Xa levels 12 hours after injection on the day of surgery and on postoperative days 1, 3, and 6.
Wound hematoma incidence was 5.3% when maximum anti-factor Xa was ≤0.2 units/ml, rising to 24.5% when levels exceeded 0.2 units/ml (P=0.0008; regression analysis P=0.002).
Postoperative thrombosis occurred in 6.3% of patients with minimum anti-factor Xa >0.1 units/ml, increasing to 14.6% at ≤0.1 units/ml and 18.8% at ≤0.05 units/ml (regression analysis P=0.03).

Structured PICO

Does the anti-factor Xa level correlate with the risk of wound hematoma and postoperative thrombosis in patients receiving enoxaparin for DVT prophylaxis after hip replacement?

Population

163 patients undergoing total hip replacement

Intervention

Enoxaparin 40 mg or 60 mg subcutaneously once daily

Outcome

Incidence of wound hematoma and postoperative thrombosishard clinical

In patients receiving once-daily enoxaparin after hip replacement, 12-hour anti-factor Xa levels should be maintained between 0.05 and 0.2 U/ml to optimize efficacy against thrombosis while minimizing bleeding risk.

Cite This Study

Levine et al. (1989) studied this question.

synapsesocial.com/papers/6a1c8a0b66d062ff2dc3ef70 https://doi.org/10.1055/s-0038-1651032

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Implication

May support anti-factor Xa monitoring after hip replacement; hypothesis-generating and requires randomized confirmation before practice change.

The Relationship between Anti-Factor Xa Level and Clinical Outcome in Patients Receiving Enoxaparine Low Molecular Weight Heparin to Prevent Deep Vein Thrombosis after Hip Replacement

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The Relationship between Anti-Factor Xa Level and Clinical Outcome in Patients Receiving Enoxaparine Low Molecular Weight Heparin to Prevent Deep Vein Thrombosis after Hip Replacement

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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