Effect of rivaroxaban on preventing deep vein thrombosis in aged diabetics with femoral neck fractures after hip replacement.

Yi-Min Zhang,Yan-Shan Sun,Xin Jiang

doi:10.1042/bsr20170289

Abstract

The present study estimates the effect of rivaroxaban on preventing deep vein thrombosis (DVT) in aged diabetics with femoral neck fractures after hip replacement. Our study consisted of 236 aged diabetics with femoral neck fractures, which were divided into the rivaroxaban and control groups. Reaction time (R time), clot formation time (K time), α angle (α), maximum amplitude (MA), clot elasticity (G) and coagulation index (CI), prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured. DVT was diagnosed by color duplex Doppler ultrasound (CDDU). The risk factors of DVT were analysed by logistic regression analysis. Compared with the control group, in the rivaroxaban group, R time and K time were extended and α, MA and G decreased 1 day before operation. One day after operation, the rivaroxaban group had less PT and APPT and lower incidence of DVT than the control group. In the two groups, preoperative and postoperative PT and APPT significantly differed. Body mass index (BMI) ≥25, abnormal coagulation indicators, use of cemented femoral hip prosthesis, high haemoglobin content and non-ankle pump exercise after operation were the risk factors for DVT. Rivaroxaban could prevent DVT in aged diabetics with femoral neck fractures after hip replacement.

Highlights

Diabetes, most prevalent among aged people, is considered as a disease in elder population [1]
Inclusion criteria: patients whose weight was between 40 and 100 kg and age was more than 40 years; diabetic patients with femoral neck fractures; patients need hip replacement as a result of femoral neck fractures; patients diagnosed with negative deep vein thrombosis (DVT) in lower limbs by preoperative color duplex Doppler ultrasound (CDDU); patients approved the medication regimen
Compared with the control group, the Reaction time (R time) extended, while α, maximum amplitude (MA) and G lowered in the rivaroxaban group 1 day before operation (P0.05)

Summary

Introduction

Most prevalent among aged people, is considered as a disease in elder population [1]. Diabetic patients are at a higher risk of hip fracture [2]. Called deep vein thrombosis (DVT), is the cause of plumping, tenderness and pain in the leg, which is defined as the formation of a blot clot within a deep vein, most commonly in the leg [4]. It is a common complication after hip replacement when patients do not receive proper medical or physical prophylaxis [5]. Recent studies have shown that anticoagulation therapies with anticoagulants, such as rivaroxaban, have high efficacy and safety in the treatment of DVT [13,14]

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