Thromboembolic disease prophylaxis in patients with hip fracture: A multimodal approach

Geoffrey H. Westrich*, Adam J. Rana, Michael A. Terry, Nicole A. Taveras, Komal Kapoor, David L. Helfet

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Objectives: To assess if pneumatic compression in conjunction with chemoprophylaxis is an effective way to reduce the incidence of deep vein thrombosis in orthopedic trauma patients sustaining fragility hip fractures. Design: Two hundred patients admitted to the authors' institution between May 1998 and June 2002 for fractures of the hip were prospectively studied. All patients were treated operatively and received the VenaFlow® calf compression device on both lower extremities immediately following surgery. Chemical prophylaxis of either aspirin (n = 67) or warfarin (n = 133) was administered in addition to mechanical compression. A noninvasive serial color flow duplex scan was performed 1 to 11 days postoperatively (mean 4.5 days) to determine the presence or absence of deep vein thrombosis. All patients were followed clinically 3 months postoperatively for a clinical evaluation of symptomatic deep vein thrombosis or pulmonary embolism. Results: Overall, the incidence of deep vein thrombosis was 3.5% (7 of 200) and included only 1 proximal thrombosis (1 out of 200, or 0.5%) and no pulmonary embolism. Five of the 7 patients positive for deep vein thrombosis were in the mechanical compression and warfarin prophylaxis group and 2 were in the aspirin arm of the study. For patients with deep vein thrombosis, the average number of risk factors was 3.71, whereas patients without clots averaged 1.75 clinical risk factors (P ≤ 0.05). Three patients in the warfarin group developed bleeding complications (1 with a gastrointestinal bleed and 2 with minor bleeding not at the operative site). No evidence of a symptomatic deep vein thrombosis or pulmonary embolism was reported within a 3-month period following hospitalization. Conclusions: Our findings suggest mechanical compression with the VenaFlow® calf compression device in conjunction with chemoprophylaxis is an effective means of reducing thromboembolic disease in this high-risk population.

Original languageEnglish (US)
Pages (from-to)234-240
Number of pages7
JournalJournal of orthopaedic trauma
Volume19
Issue number4
DOIs
StatePublished - Apr 2005

Keywords

  • Chemical prophylaxis
  • Deep venous thrombosis
  • Hip fractures
  • Mechanical prophylaxis
  • Pulmonary embolism

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Thromboembolic disease prophylaxis in patients with hip fracture: A multimodal approach'. Together they form a unique fingerprint.

Cite this