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  • Title: The post-discharge prophylactic management of the orthopedic patient with low-molecular-weight heparin: enoxaparin.
    Author: Nilsson PE, Bergqvist D, Benoni G, Björgell O, Fredin H, Hedlund U, Nicolas S, Nylander G.
    Journal: Orthopedics; 1997 Feb; 20 Suppl():22-5. PubMed ID: 9048404.
    Abstract:
    This prospective, double-blind trial was performed to determine whether 4 weeks' prophylaxis with enoxaparin after total hip replacement (THR) is more effective in protecting against deep vein thrombosis (DVT) than prophylaxis during hospitalization. Two hundred sixty-two patients undergoing THR were given enoxaparin 40 mg once daily during hospitalization (9 +/- 2 days) before being randomized at discharge to continue enoxaparin (N = 131) or receive placebo (N = 131) for a total of 1 month (30 +/- 4 days). According to intention-to-treat analysis, 43 DVT and 2 pulmonary emboli (PE) occurred in the placebo group (34.4%) versus 21 DVT and no PE in the enoxaparin group (P < 0.001). The reduction in proximal DVT was also significant (21.4 vs 6.1%; P < 0.001). No major bleeding complications developed. Prophylaxis with enoxaparin for one month significantly reduces venous thromboembolic disease in patients undergoing THR compared to conventional prophylaxis during hospitalization.
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