Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Hip
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Hip
    Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores - (BMJ)
    Rivaroxaban Reduces Risk of Venous Thrombosis Following Hip, Knee Surgeries: Presented at AHA - (DGDispatch)
    Cardiovascular diseases and risk of hip fracture - (JAMA)
    Diagnosis of Cardiovascular Disease Associated With Risk of Subsequent Hip Fracture - (DGNews)
    Combination Therapy With Zoledronic Acid/Teriparatide Has Beneficial Effects on Bone Mass Density: Presented at ACR/ARHP - (DGDispatch)

    News archive

     Recent webcasts/CME

      Webcasts/CME archive

       Recent cases - Hip
        Occlusion of the Common Femoral Artery by Cement After Total Hip Arthroplasty: A Case Report
        A Patient with Osteoarthritis and Cardiovascular Disease Presenting with Bilateral Hip Pain: A Case Report
        Chronic Asymptomatic Dislocation of a Total Hip Replacement: A Case Report
        Bipolar Hip Hemiarthroplasty in a Patient with an Above Knee Amputation: A Case Report
        Early Catastrophic Failure of Birmingham Acetabular Dysplasia Cup in Revision Arthroplasty: A Case Report

        Cases archive
          




        my personal edition > hip > news
        divider

          E-Mail this DGReview to a colleague

        DGReview


        Fondaparinux Reduces Risk of Postoperative Venous Thromboembolism After Hip Surgery

        A DGReview of :"Duration of Prophylaxis Against Venous Thromboembolism With Fondaparinux After Hip Fracture Surgery"
        Archives of Internal Medicine

        06/19/2003
        By Emma Hitt, PhD


        Extended prophylaxis with fondaparinux for 3 weeks after hip fracture surgery appears to reduce the risk of venous thromboembolism (VTE) and is well tolerated, according to the findings of a multi-centre, randomised trial.

        Previous studies have shown that treatment with the new selective factor Xa inhibitor fondaparinux, administered for up to 11 days in patients undergoing surgery for hip fracture, reduces the rate of VTE. However, the benefit of thromboprophylaxis with fondaparinux for up to 4 weeks after surgery has not been evaluated in these high-risk patients.

        Bengt I. Eriksson, MD, PhD, with the Orthopaedics Department, Sahlgrenska University Hospital/Östra, Göteborg, Sweden and colleagues conducted a trial of 656 patients undergoing hip fracture surgery.

        Patients were randomly assigned to receive prophylaxis with a once-daily subcutaneous injection of either 2.5 mg of fondaparinux sodium or placebo for 19 to 23 days. All patients had received fondaparinux for 6 to 8 days before being randomised.

        In 428 patients assessed with bilateral venography, documented symptomatic deep vein thrombosis, or pulmonary embolism, fondaparinux reduced the incidence of VTE compared with placebo from 35.0% (77/220) to 1.4% (3/208), during 3 weeks of administration after an initial 1-week prophylaxis with fondaparinux. This indicated a relative reduction in risk of 95.9% (95% confidence interval, 87.2%-99.7%; p < 0.001).

        Likewise, an additional 3 weeks of fondaparinux prophylaxis significantly reduced the incidence of proximal deep vein thrombosis by 94%, and the incidence of symptomatic VTE by 88.8% (fondaparinux versus placebo 0.3% and 2.7%, respectively; p = 0.02).

        There was a trend toward more major bleeding in the fondaparinux group compared to the placebo group (P = .06), but there was no difference in the incidence of clinically relevant bleeding (leading to death, reoperation, or critical organ bleeding) between the 2 groups, the researchers report.

        The study findings confirm that the very high risk of VTE associated with surgery for hip fracture persists longer than 11 days, Dr. Eriksson and colleagues conclude.

        The researchers note that the "very low absolute number of venous thromboembolic events observed in the fondaparinux group indicates that no particular subgroup at lower risk for VTE can be identified; thus, all patients with hip fracture surgery, and not only high-risk targeted patients, should benefit from this 1-month treatment with fondaparinux."
        Arch Intern Med 2003;163:1337-1342. "Duration of Prophylaxis Against Venous Thromboembolism With Fondaparinux After Hip Fracture Surgery"

        E-Mail this DGReview to a colleague   To print, use this version






        All contents Copyright (c) 1995-2009 Doctor's Guide Publishing Limited. All rights reserved.



        The NTK initiative. Physicians helping physicians identify Need-To-Know science
           Feedback
        Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
        Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
        1
        2
        3
        4
        5
        6
        7
        Send