Why the study?
Does extended post-discharge prophylaxis with enoxaparin reduce deep vein thrombosis and pulmonary emboli in patients undergoing total hip replacement?
Does extended post-discharge prophylaxis with enoxaparin reduce deep vein thrombosis and pulmonary emboli in patients undergoing total hip replacement?
Extended post-discharge prophylaxis with enoxaparin for 4 weeks significantly reduces venous thromboembolic disease in patients undergoing total hip replacement compared to in-hospital prophylaxis alone.
Supports extended post-discharge enoxaparin after total hip replacement; confirms prolonged VTE prophylaxis benefit in orthopedic RCTs.
ABSTRACTThis prospective, double-blind trial was performed to determine whether 4 weeks' prophylaxis with enoxaparin after total hip replacement (THR) is more effective in protecting against deep vein thrombosis (DVT) than prophylaxis during hospitalization. Two hundred sixty-two patients undergoing THR were given enoxaparin 40 mg once daily during hospitalization (9 ± 2 days) before being randomized at discharge to continue enoxaparin (N=131) or receive placebo (N=131) for a total of 1 month (30 ± 4 days). According to intention-to-treat analysis, 43 DVT and 2 pulmonary emboli (PE) occurred in the placebo group (34.4%) versus 21 DVT and no PE in the enoxaparin group (P<0.001). The reduction in proximal DVT was also significant (21.4 vs 6.1%; P<0.001). No major bleeding complications developed. Prophylaxis with enoxaparin for one month significantly reduces venous thromboembolic disease in patients undergoing THR compared to conventional prophylaxis during hospitalization.
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Nilsson et al. (1997) studied this question.
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