title: [Prophylaxis of thromboembolic events in surgery. DVT prophylaxis: a comparison of out-patient and hospitalized patients].
abstract: BACKGROUND
  The aim of this study was to compare the efficacy and tolerability of enoxaparin for preventing thromboembolism after surgery in the out-patient and in-hospital settings.
  
  
  METHODS
  A total of 2,005 out-patient and 1,360 hospitalized patients were included in the study. Prophylaxis was carried out with 20 or 40 mg enoxaparin and follow-up examination after 4-6 weeks.
  
  
  RESULTS
  Out-patients were younger (mean 48.4 vs. 58.5 years, p<0.01), had less cardiovascular comorbid diseases (7.1 vs. 20.8%, p<0.01) and underwent less complex interventions (arthroscopy 33.6 vs. 7.5%, p<0.01). Out-patients also received 20 instead of 40 mg enoxaparin more frequently (60.7 vs. 38.3%, p<0.01). The mean duration of thromboprophylaxis was reduced (12.6 vs. 15.3 days). For patients treated with 20 and 40 mg minor bleeding was observed in 1.8 and 3.4%, respectively (4.7 with 20 mg and 4.5% with 40 mg in hospital), major bleeding was 0.1% for both doses in out-patients and 0.0% with 20 mg and 0.3% with 40 mg in-hospital. Deep vein thrombosis (DVT) occurred in 0.4% of out-patients receiving 20 mg enoxaparin and 0.6% with 40 mg (0.0% with 20 mg and 0.9% with 40 mg in-hospital). There were no cases of pulmonary embolism (PE) in out-patients but PE was observed in 0.2% and 0.5% with 20 mg and 40 mg in-hospital patients, respectively.
  
  
  CONCLUSIONS
  Thromboprophylaxis with enoxaparin is well tolerated under clinical conditions as well as under out-patient treatment and severe bleeding complications are rare.
authors: Zentrum für Fußchirurgie, Fußkliniken Dr. Fecher, Ludwigstraße 4, 63739 Aschaffenburg. fecher@fusskliniken.de
authors: K
authors: K
authors: Fecher
authors: W
authors: W
authors: Ewald
authors: A
authors: A
authors: Fürst
authors: V
authors: V
authors: Hohmann
authors: P
authors: P
authors: Bramlage
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015897:Comorbidity; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000517:prevention & control*
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents