title: The post-discharge prophylactic management of the orthopedic patient with low-molecular-weight heparin: enoxaparin.
abstract: This prospective, double-blind trial was performed to determine whether 4 weeks' prophylaxis with enoxaparin after total hip replacement (THR) is more effective in protecting against deep vein thrombosis (DVT) than prophylaxis during hospitalization. Two hundred sixty-two patients undergoing THR were given enoxaparin 40 mg once daily during hospitalization (9 +/- 2 days) before being randomized at discharge to continue enoxaparin (N = 131) or receive placebo (N = 131) for a total of 1 month (30 +/- 4 days). According to intention-to-treat analysis, 43 DVT and 2 pulmonary emboli (PE) occurred in the placebo group (34.4%) versus 21 DVT and no PE in the enoxaparin group (P < 0.001). The reduction in proximal DVT was also significant (21.4 vs 6.1%; P < 0.001). No major bleeding complications developed. Prophylaxis with enoxaparin for one month significantly reduces venous thromboembolic disease in patients undergoing THR compared to conventional prophylaxis during hospitalization.
authors.affiliation: Department of Diagnostic Radiology, Malmö University Hospital, Sweden.
authors.forename: P E
authors.initials: PE
authors.lastname: Nilsson
authors.forename: D
authors.initials: D
authors.lastname: Bergqvist
authors.forename: G
authors.initials: G
authors.lastname: Benoni
authors.forename: O
authors.initials: O
authors.lastname: Björgell
authors.forename: H
authors.initials: H
authors.lastname: Fredin
authors.forename: U
authors.initials: U
authors.lastname: Hedlund
authors.forename: S
authors.initials: S
authors.lastname: Nicolas
authors.forename: G
authors.initials: G
authors.lastname: Nylander
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D004311:Double-Blind Method; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D013923:Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin