Prevention of fatal pulmonary embolism with warfarin after total hip replacement.
We studied retrospectively the efficacy of low-dose warfarin for the prevention of fatal pulmonary embolism in 1140 patients (1280 hips) undergoing total hip replacement between 1972 and 1989. The first dose, 10-20 mg, was given the night before operation and the regime was continued for 2 weeks after the procedure. Anticoagulation was aimed at achieving a therapeutic level in 4 to 5 days. All the patients were followed for 3 months. Seven died during this period and autopsy showed that 2 (0.16%) died from pulmonary embolism, one at 3 days and the other 10 days after operation. Pulmonary embolism causing symptoms, but which was not fatal, occurred in 32 patients (2.5%). Symptomatic deep vein thrombosis was present in 45 patients (3.5%). There were 14 (1.1%) massive postoperative haematoma, and 7 needed operative treatment. Low-dose warfarin can be recommended as a safe and efficient method of achieving an acceptably low incidence of postoperative thrombo-embolic complications after total hip replacement.
Suomalainen
O
O
Department of Surgery, Kuopio University Hospital, Finland.
Mäkelä
A E
AE
Harju
A
A
Jaroma
H
H
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D015996:Survival Rate; D013924:Thrombophlebitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use*
D000925:Anticoagulants; D014859:Warfarin