Key result
Continued prophylaxis with enoxaparin for 21 days after hospital discharge significantly reduced the incidence of DVT compared with placebo (7.1% vs 19.3%; P=0.018) in total hip replacement patients.
Why the study?
Does continued prophylaxis with enoxaparin reduce the incidence of deep vein thrombosis in total hip replacement patients after hospital discharge?
RCT (n=179)
Double-blind
randomized
Does continued prophylaxis with enoxaparin reduce the incidence of deep vein thrombosis in total hip replacement patients after hospital discharge?
Continued prophylaxis with enoxaparin for 21 days after hospital discharge significantly reduces the risk of deep vein thrombosis in total hip replacement patients.
Supports extended enoxaparin prophylaxis after total hip replacement discharge; confirms benefit of prolonged anticoagulation for post-discharge DVT prevention.
A prospective, randomized, double-blind trial was performed in total hip replacement patients to document the risk of deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving enoxaparin 40 mg/day during hospitalization, those without venogram-proven DVT at discharge were randomly assigned to continue prophylaxis with enoxaparin (N = 90) or receive placebo (N = 89). At the end of 21 days' treatment, intention-to-treat analysis in 173 evaluable patients demonstrated a significantly lower incidence (P = 0.018) of DVT in the enoxaparin group (7.1%; N = 6) compared with the placebo group (19.3%; N = 17). These findings were confirmed by perprotocol analysis in 155 patients. Minor bleeding episodes occurred in three patients in the enoxaparin group and one in the placebo group. Thus, total hip replacement patients have a significant risk of developing DVT after hospital discharge. Continued prophylaxis with enoxaparin is effective in reducing this risk.
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Planès et al. (1997) conducted an RCT in Total hip replacement (n=179). Enoxaparin vs. Placebo was evaluated on Deep vein thrombosis (DVT) (p=0.018). Continued prophylaxis with enoxaparin for 21 days after hospital discharge significantly reduced the incidence of DVT compared with placebo (7.1% vs 19.3%; P=0.018) in total hip replacement patients.
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