Thromboembolic complications after total hip replacement.
We conducted a retrospective analysis of 1,640 consecutive patients undergoing total hip replacement between 1990 and 1997 under general anesthesia and receiving three different prophylactic regimens. The thromboembolic prophylaxis consisted of low-dose unfractioned heparin (UFH), low-molecular-weight heparin (LMWH), or indobufen (INDO). Postoperatively, occurrence of symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) was recorded during the first 30 days after surgery and at a routine follow-up visit. Symptomatic DVT was diagnosed in 16 patients (0.9%), while PE occurred in eight patients (0.5%). Patients receiving UFH showed a higher incidence of symptomatic DVT (3.6%) than those patients receiving either LMWH (1.3%) or INDO (0.3%), with an odds ratio for developing symptomatic DVT when receiving UFH versus other treatments of 6.05 (95% confidence intervals [CI95%]: 3.63-10.07) (P=0.001). On the other hand, the diagnosis of PE was more frequently seen in patients receiving cemented hip arthroplasty (2.4%) than in patients receiving uncemented hip arthroplasty (0.34%), with an odds ratio of 3.185 (CI95%: 2.01-5.02)(P=0.05).
Borghi
B
B
Department of Anaesthesiology, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy.
Casati
A
A
D000768:Anesthesia, General; D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
D000925:Anticoagulants