Prophylaxis against venous thrombosis after total hip arthroplasty.
Venous thrombosis rates were compared in 200 patients undergoing total hip arthroplasty and randomized to receive either fixed mini-dose warfarin (1 mg daily) or adjusted-dose warfarin to maintain an international normalized prothrombin ratio (INR) of 2.0-4.0. Bilateral lower limb venography was performed between days 11 and 13 inclusive. Fixed mini-dose warfarin was associated with a significantly higher rate of total thrombosis (P less than 0.05). General anaesthesia was associated with a significantly higher rate of thrombosis than spinal anaesthesia (P less than 0.05). Adjusted-dose warfarin was associated with more bleeding complications than mini-dose warfarin although these were not attributable to excessive anticoagulation. A single death from pulmonary embolus occurred in the early postoperative period in a patient receiving adjusted-dose warfarin.
Feller
J A
JA
Department of Othopaedic Surgery, Heidelberg Repatriation Hospital, Victoria, Australia.
Parkin
J D
JD
Phillips
G W
GW
Hannon
P J
PJ
Hennessy
O
O
Huggins
R M
RM
D000768:Anesthesia, General / Q000706:statistics & numerical data; D000775:Anesthesia, Spinal / Q000706:statistics & numerical data; D004311:Double-Blind Method; D004341:Drug Evaluation; D006622:Hip Prosthesis / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D011859:Radiography; D012044:Regression Analysis; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage
D014859:Warfarin