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Submitted: 07 July 2008
HERDIN Record #: PCHRD070808020707

Comparing the efficacy and safety of low molecular weight heparin vs. warfarin for the prevention of deep venous thrombosis among patients who underwent hip or knee arthroplasty.

Mary Jennifer V. Dimayuga

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Background ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Despite modern surgical techniques and early patient mobilization aftaf the operative period, venous thromboembolism remains a frequent complication following hip or knee arthroplasty, occuring between 40-60 percent of patients undergoing such procedure without prophylaxis. With its serious and life threatening consequences, prophylaxis for deep venous thrombosis among this group of patients is necessary.

Objectives: (1) To compare the efficacy of Low molecular weight heparins vs Warfarin in preventing Deep venous thromboembolism in patients undergoing hip or knee arthroplasty; and (2) to compare the safety using low molecular weight heparin and coumadin in preventing deep venous thromboembolism.

Selection criteria ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Articles written from 1993 to 2001 comparing LMWH and Coumadin for DVT prophylaxis among patients undergoing hip and knee arthroplasty were included in this meta analysis.

Results ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Eight articles on DVT prophylaxis comparing LMWH and Warfarin were reviewed. Four trials started low molecular weight heparin 2-4 hrs pre operatively while the other 4 trials started it 6-48 hours post operatively.

Conclusion ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ The administration of anticoagulants has improved the prevention of deep venous thrombosis. The administration of LMWH was favored over warfarin for DVT prophylaxis but with a greater risk of having a clinically significant bleeding. (Author)

Publication Type
Journal
Publication Sub Type
Review Articles/Metaanalysis
Title
Philippine Heart Center Journal
Frequency
Quarterly
Publication Date
July-September 2006
Volume
12
Issue
3
Page(s)
85-88

Objectives

1. To compare the efficacy of Low molecular weight heparins vs Warfarin in preventing Deep venous thromboembolism in patients undergoing hip or knee arthroplasty.
2. To compare the safety using low molecular weight heparin and coumadin in preventing deep venous thromboembolism.

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Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)