Low-Molecular-Weight Heparin (Enoxaparin) vs Dextran 70: The Prevention of Postoperative Deep Vein Thrombosis After Total Hip Replacement

doi:10.1001/archinte.1991.00400080105020

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Vol. 151 No. 8, AUGUST 1991

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Low-Molecular-Weight Heparin (Enoxaparin) vs Dextran 70

The Prevention of Postoperative Deep Vein Thrombosis After Total Hip Replacement

The Danish Enoxaparin Study Group

Arch Intern Med. 1991;151(8):1621-1624.

Abstract

A prospective randomized study compared the thromboprophylacticefficacy and safety of a low-molecular-weight heparin (LMWH),enoxaparin (40.6 mg subcutaneously once daily), with a standardregimen of dextran 70 in patients undergoing elective totalhip replacement. Deep vein thrombosis was diagnosed by bilateralascending phlebography 7 to 11 days after operation. Two hundredforty-six patients were included and 219 were eligible for analysis.Deep vein thrombosis was diagnosed in seven of 108 patientsin the LMWH group and in 24 of 111 patients in the dextran group.Clinical symptoms of pulmonary embolism did not develop in anypatients during the study. In the postoperative period, patientsreceiving LMWH had a lower blood loss in drains and requiredfewer blood transfusions than patients receiving dextran, althoughno significant differences were noted between the groups withrespect to the total number of blood transfusions required.Bleeding events and adverse events did not differ between thegroups. None of the patients died in hospital during the study.One patient in the LMWH group died at home 15 days after theoperation. Three patients receiving dextran had developmentof symptomatic deep vein thrombosis after hospital discharge.In conclusion, enoxaparin was a more effective thromboprophylacticthan a standard regimen of dextran in patients undergoing totalhip replacement. The two regimens were equally safe under theclinical conditions.

(Arch Intern Med. 1991;151:1621-1624)

Author Affiliations

From the Departments of Orthopaedics (Drs Borris, Lassen, and Sørensen) and Radiology (Drs Schøtt and Siem-Jørgensen), Aalborg (Denmark) Hospital; Departments of Orthopaedics (Drs N. Jørgensen and Hinrichsen) and Radiology (Dr Thrane-Nielsen), Hillerød (Denmark) Hospital; Departments of Orthopaedics (Drs Hauch, S. Jørgensen, Tørholm, and Wille-Jørgensen), and Radiology (Dr Nissen), Gentofte Hospital, University of Copenhagen (Denmark); and Departments of Orthopaedics (Dr Jensen) and Radiology (Dr Hansen), Holstebro (Denmark) Hospital.

Footnotes

Accepted for publication February 11, 1991.

Read before the 11th International Congress on Thrombosis, Ljubljiana,Yugoslavia, June 26, 1990.

Reprint requests to the Venous Thrombosis Group, Departmentof Orthopaedics, Aalborg Hospital, Hobrovej, PO Box 365, DK-9100Aalborg, Denmark (Dr Borris).

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