title: Prospective study on the efficacies of fondaparinux and enoxaparin in preventing venous thromboembolism after hip fracture surgery.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a common complication in hip fracture surgery (HFS). Fondaparinux (FPX) and enoxaparin (ENO) have been reported to decrease the incidence of VTE after HFS. The purpose of this study was to determine the efficacies of FPX and ENO and the superior agent for preventing VTE after HFS by performing a prospective study in a Japanese population.
  
  
  METHODS
  Eighty-four Japanese patients who underwent HFS were assigned to either FPX (received FPX 1.5 or 2.5 mg/day for 14 days), ENO (received ENO 2000 IU once or twice/day for 14 days), or untreated control (CTRL) groups in order of surgery. All patients underwent ultrasonography of the lower extremities 7 days after HFS to evaluate the extent of deep-vein thrombosis. Incidence of VTE, D-dimer values measured at admission and 7 and 14 days after HFS, and the side effects of FPX and ENO were compared.
  
  
  RESULTS
  The incidence of VTE and the D-dimer values on days 7 and 14 in the FPX group were significantly lower than the corresponding levels in the CTRL group (P < 0.05). The D-dimer values on day 7 in the ENO group were significantly lower than those in the CTRL group, whereas the incidence of VTE was not significantly different. Side effects were observed in 3 cases: major bleeding occurred in 2 patients who received FPX, whereas minor bleeding occurred in 1 patient who received ENO.
  
  
  CONCLUSIONS
  We concluded that FPX was the superior agent for preventing VTE after HFS. However, patients receiving FPX should be monitored for bleeding.
authors.affiliation: Department of Orthopedic Surgery, Yuri-Kumiai General Hospital, 38 Yago Kawaguchi, Yurihonjo, 015-8511, Japan. satoshi@yuri-hospital.honjo.akita.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuura
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Saito
authors.forename: Toru
authors.initials: T
authors.lastname: Nakanishi
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kudo
authors.forename: Tomiko
authors.initials: T
authors.lastname: Fujiya
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D017984:Enoxaparin / Q000008:administration & dosage / Q000627:therapeutic use*; D005170:Factor X; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D015994:Incidence; D007279:Injections, Subcutaneous; D007564:Japan / Q000453:epidemiology; D008297:Male; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D011134:Polysaccharides; D005170:Factor X; D000077425:Fondaparinux