Heparin versus danaproid for prevention of venous thromboembolism after hip surgery.
OBJECTIVE
To compare the prevalence of deep vein thrombosis (DVT), pulmonary thromboembolism (PTE), and bleeding complications in patients receiving heparin or danaproid after hemiarthroplasty or osteosynthesis for hip fractures.


METHODS
37 men and 138 women aged 47 to 100 (mean, 80) years underwent either hemiarthroplasty or osteosynthesis for hip fractures; 5 patients with dementia were excluded. All patients received preoperative elastic stocking and postoperative intermittent pneumatic compression. They were divided into 3 groups based on their admission period: controls (n=71), unfractionated heparin (n=44), and danaproid sodium (n=55). Drugs were administered from postoperative day 1 to 7. At day 7, all patients undertook radioisotope venography of the legs and lung perfusion scintigraphy.


RESULTS
In the control, heparin, and danaproid groups respectively, the DVT rates were 31%, 9.1%, and 5.5%, and the PTE rates were 5.6%, 4.5%, and 1.8%. Only the DVT rate in the control group was significantly higher than that in the heparin and danaproid groups. In the heparin group, one patient had gastrointestinal bleeding, 5 developed wound haematomas, and one had leakage from the drain site for 2 weeks.


CONCLUSIONS
Danaproid sodium appeared more effective and safer than heparin, with no bleeding complications occurred.
Nakase
J
J
Department of Orthopedics, Kouseiren-Takaoka Hospital, Takaoka, Toyama, Japan. nakase1007@yahoo.co.jp
Toribatake
Y
Y
Mouri
Y
Y
Seki
H
H
Kitaoka
K
K
Tomita
K
K
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D003871:Dermatan Sulfate / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006493:Heparin / Q000627:therapeutic use*; D006497:Heparan Sulfate / Q000627:therapeutic use*; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D015995:Prevalence; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*
D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D005343:Fibrinolytic Agents; D006493:Heparin; D006497:Heparan Sulfate; C035838:danaparoid