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October 1, 1976Journal of Bone and Joint Surgery

Thromboembolism following total hip-replacement arthroplasty. The efficicy of dextran-aspirin and dextran-warfarin in prophylaxis

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Why the study?

Does combined dextran and aspirin compared to combined dextran and warfarin prevent thromboembolism in patients following total hip-replacement arthroplasty?

Population

624 patients undergoing total hip-replacement arthroplasty without a history of thromboembolism.

Comparison

Combined dextran and aspirin vs Combined dextran and warfarin

Design

Cohort

Authors

SESalvati EaHospital for Special SurgeryPLPaul F. LachiewiczDuke University

Discussion

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Implication

Dextran-aspirin may balance thromboembolism and wound risks similarly to dextran-warfarin after hip replacement; leaves open need for randomized trials before practice change.

Structured PICO

Does combined dextran and aspirin compared to combined dextran and warfarin prevent thromboembolism in patients following total hip-replacement arthroplasty?

P
Population
624 patients undergoing total hip-replacement arthroplasty without a history of thromboembolism (an additional 45 patients with a history of thromboembolism were analyzed separately).
I
Intervention
Combined dextran and aspirin
C
Comparator
Combined dextran and warfarin
O
Outcome
Incidence of thromboembolic complicationshard clinical

Both dextran-aspirin and dextran-warfarin are effective for thromboembolic prophylaxis after total hip replacement, with dextran-aspirin showing slightly higher thromboembolism rates but fewer wound complications.

Limitations

  • One-fourth of the patients on dextran-warfarin were not adequately anticoagulated despite close supervision.

Cite This Study

Ea et al. (1976) studied this question.

synapsesocial.com/papers/6a7be089ef97a97562c62703https://doi.org/10.2106/00004623-197658070-00004

Topics

Pulmonary embolism
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Also Consider

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

  1. 1Prevention of venous thromboembolism following total hip replacement. Warfarin vs dextran 401972 · 62 citations
  2. 2Prevention of Venous Thromboembolism Following Total Hip Replacement1972 · 40 citations
  3. 3Clinical Efficacy of Aspirin and Dextran for Thromboprophylaxis in Geriatric Hip Fracture Patients1993 · 11 citations
  4. 4A comparative study of dextran-70, warfarin and low-dose heparin for the prophylaxis of thrombo-embolism following total hip replacement1977 · 28 citations
  5. 5Thromboprophylaxis-in-hip arthroplasty: Dextran with graded compression or preoperative dextran compared in 150 patients1989 · 42 citations