title: Venous thromboembolism clinically detected after hip fracture surgery with prophylaxis in a clinical practice setting.
abstract: Clinical trials have shown differences in efficacy among anticoagulants used for venous thromboembolism (VTE) prophylaxis after hip fracture surgery, but the applicability of their results is limited by constraints of the clinical trial setting. We conducted this retrospective cohort study to assess VTE after hip fracture surgery in patients who received prophylaxis with dalteparin, enoxaparin, fondaparinux, or unfractionated heparin in a hospital setting. After adjustments were made for demographic differences, risk for VTE was significantly higher for dalteparin (odds ratio [OR], 1.4; 95% confidence interval [CI], 0.99-1.92), enoxaparin (OR, 1.4; 95% CI, 1.05-1.86), and unfractionated heparin (OR, 1.9; 95% CI, 1.39-2.58) compared with fondaparinux. These findings confirm the results of clinical trials in a real-world setting.
authors.affiliation: Hematology/Oncology Section, University of Oklahoma Health Sciences Center, Veterans Administration Medical Center, Oklahoma City, Oklahoma, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Comp
authors.forename: Laura E
authors.initials: LE
authors.lastname: Happe
authors.forename: Matt
authors.initials: M
authors.lastname: Sarnes
authors.forename: Eileen
authors.initials: E
authors.lastname: Farrelly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use*; D015331:Cohort Studies; D017985:Dalteparin / Q000627:therapeutic use; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D000077425:Fondaparinux; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000379:methods; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011134:Polysaccharides / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011292:Premedication / Q000379:methods*; D011336:Probability; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D017211:Treatment Failure; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D006495:Heparin, Low-Molecular-Weight; D011134:Polysaccharides; D000077425:Fondaparinux; D017985:Dalteparin