Low-molecular-weight heparinoid compared with warfarin for prophylaxis of deep-vein thrombosis in patients who are operated on for fracture of the hip: a prospective, randomized trial

A potential complication following surgery for a fractured hip is the development of deep vein thrombosis, clot formation in a deep vein. Elderly patients with hip fracture are especially at risk from the combination of injury to the leg, surgery, and immobilization. Methods of preventing thrombosis have been studied extensively in patients undergoing elective hip surgery. Newly developed heparinoids, low-molecular-weight heparin fractions, may be able to reduce the risk of thrombosis without increasing the risk of bleeding to the same extent as other anticoagulant medications. A clinical trial was undertaken of 263 patients undergoing surgical repair of hip fracture, to compare Lomoparan, a low-molecular-weight heparinoid, with warfarin (another anticoagulant) for usefulness and safety in preventing deep vein thrombosis. All patients were at least 45 years of age, and were operated on within four days of fracture. Both groups began anticoagulant treatment before surgery; one group of 132 patients received Lomoparan for seven days and then warfarin was added to the regimen, while the other group of 131 patients received only warfarin until the ninth postoperative day. Nine patients (7 percent) receiving Lomoparan developed deep vein thrombosis, compared with 28 patients (21 percent) of the warfarin-only group. The two groups did not differ significantly in loss of blood at the time of surgery, nor in need for blood transfusion. It is concluded that administration of Lomoparan is safe and effective in preventing deep vein thrombosis following surgical repair of hip fracture. (Consumer Summary produced by Reliance Medical Information, Inc.)