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Warfarin after hip fracture yielded higher DVT, pulmonary embolism rates vs low-molecular-weight heparin
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Published results showed higher rates of deep vein thrombosis and pulmonary embolism among patients prescribed warfarin after hip fracture compared with patients prescribed low-molecular-weight heparin.
“Despite extensive research on the effectiveness of various anticoagulation medications in arthroplasty patients, little data exist on the effectiveness of these drugs in the setting of hip fracture surgery,” Nikunj N. Trivedi, MD, co-author of the study, told Healio.com/Orthopedics. “Our study compared the effectiveness of warfarin and enoxaparin in preventing thromboembolic events after hip fracture surgery.”
Among 7,594 patients with hip fractures treated operatively, Trivedi and colleagues found 51.7% received warfarin and 48.3% received low-molecular-weight heparin. Overall, patients had 30- and 90-day DVT rates of 7.18% and 10.85%, respectively, as well as 30- and 90-day pulmonary embolism rates of 3.8% and 5.4%, respectively, according to results. Researchers found an overall 30-day complication rate of 12.7%.
Results showed higher 30- and 90-day DVT and pulmonary embolism rates among patients prescribed warfarin compared with low-molecular-weight heparin. Although patients prescribed warfarin had higher 30- and 90-day readmission rates, researchers noted they had lower 90- and 180-day mortality rates vs. patients prescribed low-molecular-weight heparin. Lower rates of respiratory and gastrointestinal complications and postoperative hematomas were found among patients prescribed low-molecular-weight heparin. However, researchers found patients prescribed low-molecular-weight heparin had higher rates of wound dehiscence.
“Patients in our cohort who were prescribed warfarin were more likely to have a DVT or [pulmonary embolism] PE compared to those who were prescribed enoxaparin. They were also more likely to develop a postoperative hematoma and to be readmitted within 30 and 90 days of discharge,” Trivedi said. “Based on these findings, we believe enoxaparin may be a superior chemoprophylaxis agent than warfarin in the setting of hip fracture surgery.” – by Casey Tingle
Disclosure: Trivedi reports no relevant financial disclosures.
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