Key result
The combination of graded compression stockings, heparin, and dihydroergotamine reduced the incidence of deep venous thrombosis compared to stockings and placebo (11% vs 23%; P<0.05).
Why the study?
Does the combination of graded compression stockings, heparin, and dihydroergotamine prevent postoperative thromboembolism in patients scheduled for total hip alloplasty compared to graded compression stockings and placebo?
RCT (n=205)
Does the combination of graded compression stockings, heparin, and dihydroergotamine prevent postoperative thromboembolism in patients scheduled for total hip alloplasty compared to graded compression stockings and placebo?
Absolute Event Rate: 11% vs 23%
p-value: p=< 0.05
The addition of subcutaneous heparin and dihydroergotamine to graded compression stockings significantly reduces postoperative DVT and pulmonary embolism in patients undergoing total hip alloplasty.
Supports adding heparin-dihydroergotamine to stockings for DVT prevention after hip arthroplasty; confirms combined prophylaxis benefit in this RCT.
Two hundred and five patients scheduled for total hip alloplasty were randomized to one of the following two regimes, in order to prevent postoperative thromboembolism. (1) Graded compression stockings and heparin 5000 iu/dihydroergotamine 0.5 mg twice a day subcutaneously. (2) Graded compression stockings and placebo twice a day subcutaneously. Screening for deep venous thrombosis (DVT) was carried out by 99 m Tc-plasmin scintimetry and whenever this was indicative for DVT, ascending phlebography was performed. The definitive criteria for DVT were intraluminal filling defects on phlebography. If DVT was diagnosed, pulmonary perfusion/ventilation scintigraphy was performed. In the group receiving heparin/dihydroergotamine 11 of 96 patients (11%) developed DVT and in the placebo group 25 of 109 patients (23%) developed DVT (P < 0.05). One patient in the combination treatment group and seven patients in the placebo group developed pulmonary embolism ( P < 0.05). It is concluded that the combination of graded compression stockings, low dose heparin and dihydroergotamine is superior to graded compression stockings alone in preventing thromboembolism following total hip alloplasty.
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Bjerg-Nielsen et al. (1986) conducted an RCT in Total hip alloplasty (n=205). Graded compression stockings and heparin/dihydroergotamine vs. Graded compression stockings and placebo was evaluated on Deep venous thrombosis (DVT) (p=< 0.05). The combination of graded compression stockings, heparin, and dihydroergotamine reduced the incidence of deep venous thrombosis compared to stockings and placebo (11% vs 23%; P<0.05).
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