Bleeding complications with enoxaparin for deep venous thrombosis prophylaxis.

摘要: The safest and most efficacious method of deep venous thrombosis prophylaxis remains controversial. With the use enoxaparin, a low-molecular-weight heparin, becoming ubiquitous in many institutions, we specifically examined bleeding complications related to its use. A case-control study was conducted on consecutive patients receiving enoxaparin after primary or revision total knee hip arthroplasty hemiarthroplasty. Matched controls no pharmacologic anticoagulation were identified. Patient operative characteristics, hematologic values, timing dosing analyzed as major minor complications. 152 procedures with an equal number control cases included for 304 patients. group had 23.7% complication rate compared 16.5% (P = .11). power test .35 indicated that approximately 970 would need be reviewed have at least 80% chance finding statistically significant difference. Major occurred 5 (3.3%) 2 (1.3%) .25, .21). Minor slightly higher but not 20.4% versus 15.1% .23). There significantly fewer single-joint (16.50%) than all other (32.4%). Patients first dose 10 hours more postoperatively .05). postoperative hematocrit drop greater .003) well single .0005). transfusion requirement .02) group. One patient epidural catheter developed hematoma. Although there evidence increased bleeding. low-power analysis reveals large (970-1,700) are required show difference between groups. To minimize complications, short period allow initial hemiostasis is recommended, preferential replacements. Enoxaparin used conjunction indwelling recommended.