Dalteparin vs. enoxaparin as prophylaxis for deep-vein thrombosis after total hip or knee arthroplasty: a retrospective analysis.
OBJECTIVE
To assess the clinical and economic consequences of a formulary switch from enoxaparin to dalteparin as first-line prophylaxis for deep-vein thrombosis in patients undergoing inpatient rehabilitation after total hip arthroplasty or total knee arthroplasty.


METHODS
Retrospective cohort study.


RESULTS
There were 461 patients eligible for the study. The age-adjusted risk of a deep-vein thrombosis event confirmed by duplex ultrasonography among patients treated with dalteparin was substantially lower than among patients treated with enoxaparin, whereas the age-adjusted risk of a bleeding event in the dalteparin group was also lower than that in the enoxaparin group. Adjusted per capita costs of deep-vein thrombosis prophylaxis during the rehabilitation stay were $129 lower among subjects treated with dalteparin.


CONCLUSIONS
The switch to dalteparin as a first-line therapy for deep-vein thrombosis prophylaxis in the rehabilitation period after total hip arthroplasty or total knee arthroplasty has led to substantial cost savings for Kessler Institute without compromising patient care.
Krotenberg
R
R
Kessler Institute for Rehabilitation, West Orange, New Jersey 07052, USA.
Adler
U
U
Pomeranz
B
B
Miller
J D
JD
Russell
M W
MW
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000191:economics; D019645:Arthroplasty, Replacement, Knee / Q000191:economics; D003365:Costs and Cost Analysis; D017985:Dalteparin / Q000627:therapeutic use*; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000191:economics / Q000517:prevention & control*
D000925:Anticoagulants; D017984:Enoxaparin; D017985:Dalteparin