A RCT study of Rivaroxaban, low-molecular-weight heparin, and sequential medication regimens for the prevention of venous thrombosis after internal fixation of hip fracture

Tang, Yilun; Wang, Kunzheng; Shi, Zhibin; Yang, Pei; Dang, Xiaoqian

doi:10.1016/j.biopha.2017.05.107

Cited by 33 publications

(34 citation statements)

References 33 publications

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“…The previous studies reported lower incidence rates than that in our study, ranging from 11.1% to 32.8% preoperatively or postoperatively. 4 – 6 The reasons are varied. First, most studies that detected DVT were focused on the injured limb, 4 – 6 limiting the data to those from uninjured limbs.…”

Section: Discussionmentioning

confidence: 99%

“… 4 – 6 The reasons are varied. First, most studies that detected DVT were focused on the injured limb, 4 – 6 limiting the data to those from uninjured limbs. The incidence reported by Mok was 14.3%, 9 with a preoperative incidence of 13.60% and a postoperative incidence of 25.05%.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of DVT of the hip after trauma is reported to range from 11.1% to 32.8% 4 – 6 in recent studies. Pooling data from the injured limbs, Song et al reported that 29.4% of preoperative patients have DVT, and the postoperative incidence has increased to 32.8%.…”

Section: Introductionmentioning

confidence: 99%

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Deep vein thrombosis in bilateral lower extremities after hip fracture: a retrospective study of 463 patients

Zhang¹,

Wei²,

Huang³

et al. 2018

CIA

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ObjectiveTo investigate the incidences of deep vein thrombosis (DVT) before and after operation in inpatients with hip fractures in both lower extremities.Patients and methodsWe collected the clinical data of 463 patients with lower extremities fractures who presented at Xi’an Honghui Hospital between July 1, 2014, and October 31, 2016 and met all the inclusion criteria. Doppler ultrasonography was used to diagnose DVT. The patients were examined preoperatively and postoperatively and divided into the thrombosis and non-thrombosis group according to the ultrasonographic findings. We divided the DVT cases into central, peripheral, and mixed thromboses.ResultsThe incidence of preoperative DVT was 34.98%, and the prevalence of DVT on the uninjured side was 13.60%. This composition ratio increased to 57.23% postoperatively, and the prevalence of DVT on the uninjured side was 25.05%. Age (odds ratio [OR], 1.03; 95% CI: 1.01–1.04; P=0.002), venous thrombosis at admission (OR, 4.05; 95% CI, 2.30–7.13; P=0.000), and the days between the fracture and the operation (OR, 1.10; 95% CI, 1.02–1.20; P=0.020) were the independent risk factors of preoperative DVT. Coronary heart disease (OR, 1.85; 95% CI: 1.18–2.89; P=0.007), venous thrombosis at admission (OR, 22.35; 95% CI: 6.78–73.60; P=0.000), days between fracture and operation (OR, 1.06; 95% CI: 1.01–1.11; P=0.021), and blood loss (OR, 1.002; 95% CI: 1.000–1.003; P=0.014) were independent risk factors of postoperative DVT.ConclusionThe actual incidence of DVT after hip fracture may be underestimated. The incidences of preoperative and postoperative DVTs and the incidence of DVT on the uninjured limb were high.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Deep vein thrombosis in bilateral lower extremities after hip fracture: a retrospective study of 463 patients

Zhang¹,

Wei²,

Huang³

et al. 2018

CIA

View full text Add to dashboard Cite

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“…Extended prophylaxis with LMWH is inconvenient, has low patient compliance, and increases the cost to patients who have undergone THA, TKA, and HFS. The rivaroxaban was not suitable for patients with renal insufficiency, low‐income patients, and patients with a high risk of bleeding.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy and Safety of Aspirin and Rivaroxaban Following Enoxaparin Treatment for Prevention of Venous Thromboembolism after Hip Fracture Surgery

Huang

Xing

Zeng

et al. 2019

Orthopaedic Surgery

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Objective To compare the efficacy and safety of aspirin with rivaroxaban following treatment with enoxaparin for prevention of venous thromboembolism (VTE) after hip fracture surgery (HFS). Methods A total of 390 patients were enrolled in the trial. According to an odd or even number at the end of their registration number, the patients were divided into the aspirin group (n = 198) and the rivaroxaban group (n = 192). All patients were given enoxaparin subcutaneous injection after the operation and returned to the routine dose the next day until postoperative day five. The patients in the aspirin group received an additional 16 days of thromboprophylaxis with 100 mg of aspirin once daily. The rivaroxaban group was assigned to receive an additional 16 days of thromboprophylaxis with 10 mg of oral rivaroxaban once daily. Patients were followed for 90 days regarding VTE and bleeding complications. Results The incidence of VTE in the aspirin group and rivaroxaban group was 6.6% (13/198) and 5.7% (11/192), respectively (P = 0.83). The rate of major bleeding events occurred in two (1.0%) patients in the aspirin group and in one patient (0.5%) in the rivaroxaban group (P = 1.0). A combination of major bleeding and clinically relevant nonmajor bleeding occurred in five patients (2.5%) in the aspirin group and in six patients (3.1%) in the rivaroxaban group (P = 0.77). During the 90‐day follow‐up, a pulmonary embolism developed in one patient (0.5%) in the aspirin group and none in the rivaroxaban group (P = 1.0). Conclusions Extended prophylaxis for 21 days with aspirin was equivalent to the direct oral anticoagulant rivaroxaban after hip fracture surgery with an initial 5‐day postoperative course of enoxaparin. Aspirin may be an effective, safe, convenient, and cheap alternative for extended prophylaxis after hip fracture surgery.

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“…Low molecular weight heparin, a low molecularvolume heparin made by de-polymerization of normal heparin, has relatively strong Xa factor activity (about 8 times stronger than normal heparin). High-activity Xa factor inhibits the antithrombus and bleeding effects of drugs, and can effectively reduce the adverse reaction of bleeding [14]. Some researchers have reported that the use of low molecular weight heparin is associated with small individual differences, significant anticoagulation effects, efficient temperature control, and less adverse reactions post-application [15].…”

Section: Discussionmentioning

confidence: 99%

Anti-thrombotic effect of combination of low molecular heparin and Xueshuantong after replantation of amputated finger

Huanwei¹,

Yang²,

Zhang³

et al. 2019

Trop. J. Pharm Res

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Purpose: To study the effects of low molecular heparin combined with Xueshuantong in preventing thrombosis after replantation of amputated finger. Methods: The treatment group (38 patients) was given 4500 IU of low molecular heparin sodium i.h. (hypodermic injection), q.d.(once daily), with 200 mL of 150 mg Xueshuantong injection and 5 % glucose injection, i.v.d. (intravenous drip), b.i.d. (twice daily). The control group received low molecular heparin sodium at 4500 IU i.h., q.d. alone. Treatment was for 3 days. Thereafter, D-dimer, fibrinogen, hemoglobin, platelets, prothrombin time (PT) and blood coagulation of patients in the 2 groups before and after treatment were compared. Differences in vasospasm, vascular thrombosis, finger necrosis, therapeutic effects and adverse reactions in patients in the 2 groups after treatment were recorded. Results: There were significant improvements in fibrinogen, platelet, PT levels, and blood coagulation time after treatment, with improvements better in the treatment group than in the control group (p < 0.05). Vasospasm cases (3) were lower in the treatment group than in the control group (8, p < 0.05), while vascular thrombosis and finger necrosis in both groups were comparable. Therapeutic effects and recovery were better in the treatment group than in the control group (p < 0.05). Conclusion: Combined injection of Xueshuantong and low molecular heparin exerts antithrombotic effects after replantation of amputated finger, improves coagulation function, and reduces incidence of vasospasm. It has better therapeutic effects than low molecular heparin, and it seems safe.

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A RCT study of Rivaroxaban, low-molecular-weight heparin, and sequential medication regimens for the prevention of venous thrombosis after internal fixation of hip fracture

Cited by 33 publications

References 33 publications

Deep vein thrombosis in bilateral lower extremities after hip fracture: a retrospective study of 463 patients

Deep vein thrombosis in bilateral lower extremities after hip fracture: a retrospective study of 463 patients

Comparison of the Efficacy and Safety of Aspirin and Rivaroxaban Following Enoxaparin Treatment for Prevention of Venous Thromboembolism after Hip Fracture Surgery

Anti-thrombotic effect of combination of low molecular heparin and Xueshuantong after replantation of amputated finger

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