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I have read with great interest the article of Eriksson and Lassen regarding postdischarge thromboprophylaxis in patients who have undergone hip fracture surgery.¹ However, the rationale of their assumptions of the venous thromboembolism (VTE) rate at day 28 in the 4-week fondaparinux group is not clear. What is the rationale to take a 1.4-fold increase of the VTE incidence at day 7, resulting in an expected deep vein thrombosis (DVT) rate of 11.4% at day 28, as the basis of the sample size calculation? The observed DVT incidence at day 28 of 1.3% in the 4-week fondaparinux group indicates that this assumption was incorrect.

In their Pentasaccharide in Hip-Fracture Surgery (PENTHIFRA) trial, which investigated fondaparinux vs enoxaparin for thromboprophylaxis after hip fracture surgery, the same authors reported that fondaparinux resulted in a 56% reduction of VTE to a residual incidence of 8.3% after 1 week of fondaparinux treatment.² In view . . . [Full Text of this Article]

Michael T. Nurmohamed, MD, PhD
Amsterdam, the Netherlands

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