Key result
Dextran 40 plus postoperative acenocoumarin was more effective than acenocoumarin alone, and subcutaneous heparin at 5000 IU twice daily resulted in a DVT incidence of 5.9%.
Why the study?
Does dextran 40 or subcutaneous heparin reduce postoperative deep vein thrombosis compared to acenocoumarin alone in surgical patients?
RCT (n=313)
Double-blind
Does dextran 40 or subcutaneous heparin reduce postoperative deep vein thrombosis compared to acenocoumarin alone in surgical patients?
Dextran 40 combined with acenocoumarin, or adequate doses of subcutaneous heparin (5000 IU twice daily), effectively prevent postoperative DVT compared to acenocoumarin alone.
Supports combined dextran 40-acenocoumarin or heparin 5000 IU BID for postoperative DVT prevention; extends RCT evidence on antithrombotic regimens in surgery.
A double-blind study was carried out to investigate the effectiveness of several preventive regimens in postoperative deep vein thrombosis (DVT). The regimens consisted of postoperative (p.o.) acenocoumarin, dextran 40 + p.o. acenocoumarin, subcutaneous (s.c.) heparin alone and s.c. heparin + p.o. acenocoumarin. The 313 patients studied were stratified according to age (40-60 vs. less than 60 years) and type of operation (laparotomy, thoracotomy, hip replacement). Dextran 40 + p.o. acenocoumarin was more effective than p.o. acenocoumarin alone, which acted as control. Subcutaneous heparin alone or together with p.o. acenocoumarin was not more effective than p.o. acenocoumarin alone during the first part of the study, when about 4000 IU twice daily were administered accidentally. When the dose had been changed to 5000 IU twice daily, better results were obtained (DVT) incidence 5.9%). The results were strongly influenced by age and type of operation. Almost no DVT occurred in patients below 60 years of age with elective abdominal surgery. The incidence of perfusion disturbances in lung scans in patients with DVT was lowest in those treated with s.c. heparin in combination with acenocoumarin.
No takes yet. Share an insight, caveat, or question.
Geloven et al. (1977) conducted an RCT in Postoperative deep vein thrombosis (DVT) (n=313). Dextran 40 + p.o. acenocoumarin, s.c. heparin alone, or s.c. heparin + p.o. acenocoumarin vs. p.o. acenocoumarin alone was evaluated on Postoperative deep vein thrombosis (DVT). Dextran 40 plus postoperative acenocoumarin was more effective than acenocoumarin alone, and subcutaneous heparin at 5000 IU twice daily resulted in a DVT incidence of 5.9%.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: