The prevention of pulmonary embolism in total hip arthroplasty. Evaluation of low-dose warfarin therapy.
The efficacy of low-dose warfarin therapy for prophylaxis of venous thromboembolic disease was studied prospectively in a group of 1,392 patients undergoing cemented total hip arthroplasty between 1978 and 1985. The incidence of both symptomatic and asymptomatic pulmonary emboli was determined after surgery in all patients using ventilation-perfusion lung scanning as the diagnostic endpoint. The total incidence of postoperative pulmonary embolus was 3.2%, with two-thirds asymptomatic and one-third symptomatic pulmonary emboli. There were no fatalities due to pulmonary embolism in the entire patient population. Bleeding complications requiring surgical intervention developed in 2.4% of patients. The authors conclude that low-dose warfarin therapy is a safe and easily administered form of inpatient treatment for prophylaxis of venous thromboembolic disease in all total hip arthroplasty patients and has demonstrated complete protection against fatal pulmonary embolism in this population.
Balderston
R A
RA
Thomas Jefferson University, Philadelphia, Pennsylvania.
Graham
T S
TS
Booth
R E
RE
Rothman
R H
RH
D000368:Aged; D004341:Drug Evaluation; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use*
D014859:Warfarin