Low-molecular-weight heparin prophylaxis using dalteparin extended out-of-hospital vs in-hospital warfarin/out-of-hospital placebo in hip arthroplasty patients -: A double-blind, randomized comparison
Low-molecular-weight heparin prophylaxis using dalteparin extended out-of-hospital vs in-hospital warfarin/out-of-hospital placebo in hip arthroplasty patients -: A double-blind, randomized comparison
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DOI：
10.1001/archinte.160.14.2208
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发表时间：
2000-07-24
影响因子：
--
通讯作者：
Brant, R
中科院分区：
文献类型：
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作者：
Hull, RD;Pineo, GF;Brant, R
背景资料：在美国或加拿大，没有随机试验直接评价髋关节置换术患者是否需要延长院外血栓预防。不确定性，以扩大预防需要在北美患者是复杂的早期出院，导致在一个短的thromboproteinationinterval.Methods：为了解决这一不确定性，我们进行了一项随机双盲试验，在569例接受髋关节置换术比较使用达肝素：在术前即刻或术后早期开始服用华法林钠，并在院外延长至35天的总间隔，在院外使用华法林钠和安慰剂。对于术前、术后和联合达肝素组中具有可解释的静脉造影的患者，分别在1.3%、0.7%（P=.04）和1.0%（P=.02）的患者中观察到院外新发近端静脉血栓形成，而在院内华法林/院外安慰剂组中为4.8%。所有深静脉血栓形成的累积发生率分别为30/174例（17.2%）（P
Background: No randomized trials have directly evaluated the need for extended out-of-hospital thromboprophylaxis for patients who have hip arthroplasty in the United States or Canada. The uncertainty as to the need for extended prophylaxis in North American patients is complicated by early hospital discharge, resulting in a short thromboprophylaxis interval.Methods: To resolve this uncertainty, we performed a randomized double-blind trial in 569 patients who underwent hip arthroplasty comparing the use of dalteparin: sodium started immediately before surgery or early after surgery and extended out-of-hospital to an overall interval of 35 days with the use of warfarin sodium inhospital and placebo out-of-hospital.Results: For patients with interpretable venograms in the preoperative, postoperative, and combined dalteparin groups, new proximal vein thrombosis out-of-hospital was observed in 1.3%, 0.7% (P=.04), and 1.0% (P=.02) of patients, respectively, compared with 4.8% in the in-hospital warfarin/out-of-hospital placebo group. The respective overall cumulative frequencies of all deep vein thrombosis were 30 (17.2%) of 174 patients (P