Key result
Fondaparinux use after orthopedic or trauma surgery was associated with in-hospital occurrence rates of 2.5% for VTE, 21.8% for major bleeding, and 0.0% for death.
Why the study?
While the efficacy of fondaparinux for orthopedic surgery has been reported in foreign studies, relevant evidence in Chinese patients is lacking.
What are the occurrence rates and risk factors for in-hospital VTE, major bleeding, and death in Chinese patients receiving fondaparinux after orthopedic or trauma surgery?
Observational (n=1,258)
Yes
What are the occurrence rates and risk factors for in-hospital VTE, major bleeding, and death in Chinese patients receiving fondaparinux after orthopedic or trauma surgery?
In Chinese patients undergoing orthopedic or trauma surgery, fondaparinux prophylaxis was associated with a low rate of in-hospital VTE (2.5%) and no deaths, though major bleeding occurred in 21.8% of patients.
May inform fondaparinux use after orthopedic surgery in Chinese patients; hypothesis-generating and requires prospective validation.
AIM: Fondaparinux is a synthetic anticoagulant that inhibits thrombosis by suppressing factor Xa. The efficacy of fondaparinux for orthopedic surgeries has been revealed by several foreign studies; however, relevant evidence in Chinese patients is lacking. This study intended to investigate the occurrence rate and risk factors of in-hospital venous thromboembolism (VTE), major bleeding, and death in patients receiving fondaparinux after orthopedic surgery or trauma surgery. METHODS: Totally, 1258 patients who received fondaparinux after orthopedic surgery or trauma surgery were retrospectively enrolled. Meanwhile, in-hospital VTE, major bleeding, and death were obtained for assessment. Besides, adverse events were recorded. RESULTS: The occurrence rates of in-hospital VTE, major bleeding, and death were 2.5%, 21.8%, and 0.0%, respectively. The multivariate logistic regression analysis revealed that only age (> 60 years vs. ≤ 60 years) (odd ratios (OR) = 3.380, P = 0.013) was independently correlated with increased risk of in-hospital VTE. Additionally, osteoarthritis diagnosis (OR = 3.826, P < 0.001), femoral head necrosis diagnosis (OR = 1.809, P = 0.034), hip replacement (vs. internal fracture fixation) (OR = 2.199, P = 0.007), knee replacement (vs. internal fracture fixation) (OR = 2.781, P = 0.002), and serum creatinine (abnormal vs. normal) (OR = 1.677, P = 0.012) were independently linked to a higher risk of in-hospital major bleeding. Moreover, the common adverse events included pain (56.6%), wound bleeding (23.0%), increased drainage (5.2%), etc. CONCLUSION: Fondaparinux realizes low occurrence rates of in-hospital VTE and major bleeding with tolerable adverse events in patients receiving orthopedic surgery or trauma surgery.
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Ding et al. (2023) conducted an observational in Orthopedic surgery or trauma surgery (n=1,258). Fondaparinux was evaluated on In-hospital VTE. Fondaparinux use after orthopedic or trauma surgery was associated with in-hospital occurrence rates of 2.5% for VTE, 21.8% for major bleeding, and 0.0% for death.
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