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August 1, 1985Journal of Bone and Joint Surgery - British Volume

Heparin and dihydroergotamine prophylaxis against thrombo-embolism after hip arthroplasty

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Why the study?

Does a combination of heparin and dihydroergotamine prevent postoperative fatal and non-fatal emboli in patients undergoing hip replacement?

Population

500 consecutive patients undergoing hip replacement

Design

Cohort

Follow-up

four weeks

Authors

KVKakkar VvKing's College - North CarolinaPFPJ FokMWMurray WjFood and Agriculture Organization of the United Nations

Discussion

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Implication

Low PE rates with heparin-dihydroergotamine after hip replacement support further study; leaves open efficacy versus controls pending randomized trials.

Key Points

  • To evaluate the efficacy and safety of combined heparin and dihydroergotamine in preventing fatal and non-fatal postoperative thromboembolism after hip replacement.
  • Prospective cohort study of consecutive patients (N=500) undergoing total hip replacement.
  • Administered postoperative thromboprophylaxis using a combination of heparin and dihydroergotamine with follow-up through hospital discharge or four weeks post-surgery.
  • Deep-vein thrombosis occurred in 131 patients (26.2%), with 99 restricted to the operated limb, 13 to the contralateral limb, and 19 occurring bilaterally.
  • Overall four-week postoperative mortality was 1.8% (n=9), with 1 patient (0.2%) dying from major pulmonary embolism, while 3 patients (0.6%) developed non-fatal pulmonary emboli.
  • Complications included excessive bleeding in 21 patients (4.2%), leading to prophylaxis cessation in 19, and wound haematomas in 25 patients (5.0%).

Structured PICO

Does a combination of heparin and dihydroergotamine prevent postoperative fatal and non-fatal emboli in patients undergoing hip replacement?

P
Population
500 consecutive patients undergoing hip replacement
I
Intervention
Combination of heparin and dihydroergotamine
O
Outcome
Postoperative fatal and non-fatal embolihard clinical

The combination of heparin and dihydroergotamine appears effective for prophylaxis against pulmonary embolism after total hip replacement, with an acceptable risk of bleeding.

Cite This Study

Vv et al. (1985) studied this question.

synapsesocial.com/papers/6a827d2fca5f0d7ba374ba0dhttps://doi.org/10.1302/0301-620x.67b4.4030846

Topics

Pulmonary embolism
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