Original Research
Venous Thromboembolism Clinically Detected After Hip Fracture Surgery With Prophylaxis in a Clinical Practice Setting
Am J Orthop. 2008 September;37(9):470-475
Author and Disclosure Information
*See Commentary and Response: Am J Orthop. 2008;37(10):502, 509.
Phillip Comp, MD, Laura E. Happe, PharmD, MPH, Matt Sarnes, PharmD, and Eileen Farrelly, MPH
Dr. Comp is Professor of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center, Veterans Administration Medical Center, Oklahoma City, Oklahoma.
Dr. Happe is Associate Director, Dr. Sarnes is Executive Director, and Ms. Farrelly is Associate Director, Xcenda, Palm Harbor, Florida.
Clinical trials have shown differences in efficacy among anticoagulants used for venous thromboembolism (VTE) prophylaxis after hip fracture surgery, but the applicability of their results is limited by constraints of the clinical trial setting. We conducted this retrospective cohort study to assess VTE after hip fracture surgery in patients who received prophylaxis with dalteparin, enoxaparin, fondaparinux, or unfractionated heparin in a hospital setting. After adjustments were made for demographic differences, risk for VTE was significantly higher for dalteparin (odds ratio [OR], 1.4; 95% confidence interval [CI], 0.99-1.92), enoxaparin (OR, 1.4; 95% CI, 1.05-1.86), and unfractionated heparin (OR, 1.9; 95% CI, 1.39-2.58) compared with fondaparinux. These findings confirm the results of clinical trials in a real-world setting.