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Peter J. Powers, MD; Michael Gent, MSc; Richard M. Jay, MD; Denise H. Julian, MSc; A. G. G. Turpie, MB; Mark Levine, MD, MSc; Jack Hirsh, MD

Arch Intern Med. 1989;149(4):771-774.

Abstract
• A randomized trial was carried out with 194 patients to compare the effectiveness of sodium warfarin or aspirin with that of placebo in the prevention of venous thromboembolism after surgery for fractured hip. Prophylaxis was commenced postoperatively and continued for 21 days or until patient discharge, whichever was earlier. All patients underwent surveillance with iodine 125–fibrinogen leg scanning and impedance plethysmography, with subsequent venography. Venous thromboembolism occurred in 13 patients (20.0%) in the warfarin group, 27 patients (40.9%) in the aspirin group, and 29 patients (46.0%) in the placebo group. Proximal vein thrombosis or pulmonary embolism occurred in 6 patients (9.2%) in the warfarin group, 7 patients (10.6%) in the aspirin group, and 19 patients (30.2%) in the placebo group. The results of this study show that sodium warfarin therapy is safe and effective in preventing thromboembolic complications in patients undergoing surgery for fractured hip, and that aspirin therapy is an equally safe and effective method for preventing proximal vein thrombosis or pulmonary embolism.

(Arch Intern Med. 1989;149:771-774)

Author Affiliations
From the Departments of Pathology (Dr Powers), Clinical Epidemiology and Biostatistics (Mr Gent and Ms Julian), and Medicine (Drs Jay, Turpie, Levine, and Hirsh), McMaster University, Hamilton, Canada.

Footnotes
Accepted for publication December 6,1988.

Reprint requests to St Joseph's Hospital, 50 Charlton Ave E, Hamilton, Ontario, Canada L8N 4A6 (Dr Powers).

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