The use of enoxaparin for long-term prevention of deep vein thrombosis in orthopedics and traumatology
Surgical interventions in orthopedics and traumatology are associated with high risk of venous thromboembolic compli- cations and require prolonged use of low-molecular weight heparins.Aim. To evaluate the efficacy and safety of enoxaparine in orthopedics and traumatology and to identify factors that influence the duration of thromboprophylaxis.Material and methods. Patients over 18 years were enrolled into open-label, prospective study after major ortho- pedic surgery. Enoxaparin 40 mg daily was used for 2-5 weeks depending on the risk of deep vein thrombosis and duration of immobilization. The primary end-point was the percent of patients without venous thromboembolism at the end of the study. We also used special questionnaire to assess the atti- tude of patients to the injections of enoxaparine.Results. 881 patients (average age 54,9 years, 389 male and 492 female) were included. The indications for enoxa- parine treatment included total hip arthroplasty (49,1%), hip fracture surgery (25,1%) and other major ortopedic surgery and trauma. At the end of the study there were no cases of symptomatic deep vein thrombosis or pulmonary embolism. The average duration of thromboprophylaxis was 20,7±12,0 days. The majority of patients (67,1%) continued treatment only in the hospital and stopped it after discharge. The dura- tion of treatment was longer in patients with concomitant dis- eases (p<0,001) while the age and type of surgery did not inluence the duration of enoxaparin use. Majority of patients did not experience significant pain or itching after injections. The mean diameter of bruise was 13,4±9,9 mm.Conclusion. Enoxaparin is safe, effective and convenient antithrombotic treatment in orthopedics and traumatology.