title: Dabigatran vs. low molecular weight heparin in preventing venous thromboembolism after elective hip and knee arthroplasty: evaluation of selected clinical parameters.
abstract: One of the most frequently performed surgical procedures in orthopaedy and traumatology are total arthroplasty of the hip and the knee. Patients who are undergoing those treatment are exposed to thromboembolic complications. It is necessary to prevent them against thromboembolic complications. Current standard practice for anticoagulant prophylaxis to prevent venous thromboembolism after total hip or knee arthroplasty includes subcutaneous low-molecular weight heparin. Dabigatran etexilate is an oral, reversible direct thrombin inhibitor, with predictable and reproducible pharmacodynamic effects and pharmacokinetic characteristics that permit once-daily dosing.    The aim of this study was to evaluate the incidence of venous thromboembolism (measured using Doppler ultrasonography), pulmonary embolism and mortality after using both types of prophylaxis. Also evaluated the safety of medicines, examining the post-operative blood loss, decreased hematocrit and hemoglobin. We analyzed the incidence of complications by assessing the state of local inflammation, the level of C-reactive protein.    There was no significant difference in the safety of the oral and subcutaneous thromboprophylaxis in patients undergoing either total hip or knee replacement. Blood loss after surgery, duration of surgery, decrease of hematocrit and hemoglobin were not significantly different. None of the both drugs did not differ significantly in the incidence of inflammatory complications a systemic and a local. In the studied population, the effectiveness of thromboprophylaxis was high.
authors.affiliation: Department of Orthopaedics and Traumatology Specialist Hospital in Kościerzyna, Kościerzyna, Poland. dawidmrozik@gmail.com
authors.forename: Dawid
authors.initials: D
authors.lastname: Mrozik
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Jackiewicz
authors.forename: Marek
authors.initials: M
authors.lastname: Krzemiński
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001562:Benzimidazoles / Q000008:administration & dosage*; D000069604:Dabigatran; D004305:Dose-Response Relationship, Drug; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011725:Pyridines / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D054556:Venous Thromboembolism / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D011725:Pyridines; D000069604:Dabigatran