Heparin versus Danaproid for Prevention of Venous Thromboembolism after Hip Surgery

• Published in: Journal of orthopaedic surgery (Hong Kong) 2009-04, Vol.17 (1), p.6-9
• Main Authors: Nakase, J, Toribatake, Y, Mouri, Y, Seki, H, Kitaoka, K, Tomita, K
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Blood clots; Blood transfusions; Chondroitin Sulfates - therapeutic use; Dermatan Sulfate - therapeutic use; Drug therapy; Female; Fibrinolytic Agents - therapeutic use; Fracture Fixation, Internal - adverse effects; Heparin - therapeutic use; Heparitin Sulfate - therapeutic use; Hip Fractures - surgery; Hip joint; Humans; Male; Middle Aged; Postoperative Hemorrhage - epidemiology; Prevalence; Risk factors; Venous Thromboembolism - epidemiology; Venous Thromboembolism - prevention & control
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/230949900901700102

Purpose. To compare the prevalence of deep vein thrombosis (DVT), pulmonary thromboembolism (PTE), and bleeding complications in patients receiving heparin or danaproid after hemiarthroplasty or osteosynthesis for hip fractures. Methods. 37 men and 138 women aged 47 to 100 (mean, 80) years underwent either hemiarthroplasty or osteosynthesis for hip fractures; 5 patients with dementia were excluded. All patients received preoperative elastic stocking and postoperative intermittent pneumatic compression. They were divided into 3 groups based on their admission period: controls (n=71), unfractionated heparin (n=44), and danaproid sodium (n=55). Drugs were administered from postoperative day 1 to 7. At day 7, all patients undertook radioisotope venography of the legs and lung perfusion scintigraphy. Results. In the control, heparin, and danaproid groups respectively, the DVT rates were 31%, 9.1%, and 5.5%, and the PTE rates were 5.6%, 4.5%, and 1.8%. Only the DVT rate in the control group was significantly higher than that in the heparin and danaproid groups. In the heparin group, one patient had gastrointestinal bleeding, 5 developed wound haematomas, and one had leakage from the drain site for 2 weeks. Conclusion. Danaproid sodium appeared more effective and safer than heparin, with no bleeding complications occurred.