Improvements in the prevention of postoperative venous thromboembolism in hip fracture patients.
Hip fracture surgery carries a high risk of venous thromboembolism and, until recently, was poorly investigated. The efficacy and safety of fondaparinux, a new synthetic antithrombotic, were investigated in two large, thromboprophylaxis studies. Results of the Penthifra study, which was a randomized, double-blind phase III trial, showed that 1 week of fondaparinux, compared with enoxaparin, significantly reduced venous thromboembolic events from 19.1% to 8.3% (relative risk reduction: 56.4%; P<.001) without increasing bleeding risk. Penthifra Plus results showed that extending fondaparinux prophylaxis from 1 to 4 weeks was well tolerated and, compared to placebo, significantly reduced delayed venous thromboembolism events from 35% to 1.4% (relative risk reduction: 95.9%; P<.001). Based on these findings, 4-week fondaparinux treatment may become the standard thromboprophylaxis after hip fracture surgery.
Eriksson
Bengt I
BI
Department of Orthopedics, Sahlgrenska University Hospital/OSTRA, S-41685 Göteborg, Sweden.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D004334:Drug Administration Schedule; D017984:Enoxaparin / Q000008:administration & dosage; D005260:Female; D000077425:Fondaparinux; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000008:administration & dosage; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000188:drug therapy / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D011859:Radiography; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D015996:Survival Rate; D013923:Thromboembolism / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016896:Treatment Outcome
D000925:Anticoagulants; D017984:Enoxaparin; D011134:Polysaccharides; D000077425:Fondaparinux