Early Preoperative Thromboprophylaxis with Klexane® in Hip Fracture Surgery: A Placebo-Controlled Study

Abstract

The aim of this study was to evaluate any possible benefits of early thromboprophylactic treatment in the preven tion of deep vein thrombosis (DVT) in high-risk hip fracture patients. Within 30 months, 239 patients were included in a double-blind placebo-controlled study. With the diagnosis of hip fracture confirmed, patients received either 40-mg Enoxa parin s.c. or placebo once daily until operation. Postoperatively, all patients received 40-mg Enoxaparin s.c. once daily until phlebography. Phlebography was first performed on the oper ated leg, and with no thrombosis detected, the other leg was investigated as well. The two groups did not differ demograph ically. Eighty-five patients were excluded. Eight patients died during the study period. The remaining 146 patients had as cending phlebography performed and 24 patients (16.4%) de veloped DVT. Nine (12%) of 75 patients in the Klexane® and 15 (21 %) of 72 patients in the placebo group developed DVT. The risk ratio was 0.58 (95% confidence limits 0.27-1.25) and p = .15 (X2 test). There was no difference in perioperative bleeding or transfusion requirements. We conclude that Klex ane® is an effective and safe thromboprophylactic agent in hip fracture patients. Key Words: Hip fracture—Thrombopro phylaxis—Low—molecular heparin.