Abstract

Introduction: Our research aims to evaluate the effectiveness of thromboprophylaxis using enoxaparin in patients undergoing hip replacement.
 Methods: A retrospective cohort study was conducted based on medical records of patients aged 40 years and older undergoing hip replacement. Exclusion criteria included patients who had used anticoagulants to prevent other diseases, patients with a history of chronic renal failure, liver failure, cancer or allergy to anticoagulants, and patients with indicated mechanical prophylaxis. In our study, 65 patients were randomized into 2 groups - the control group and the venous thromboembolism (VTE) prophylaxis group (receiving subcutaneous enoxaparin 40 mg daily for 7 - 14 days). Preventive effectiveness was evaluated based on the comparison of VTE incidence after surgery between the groups.
 Results: In our study, most of the patients were over 60 years old (79.2%). No case of pulmonary embolism was recorded. There were 11 patients in the control group (17.2%) who developed deep venous thrombosis (DVT) versus 2 patients in the prophylaxis group (3.1%). After adjusting for postoperative hospital stay, use of enoxaparin reduced the risk of DVT by 89.7% (OR 0.103, 95% confidence interval 0.019-0.569, p=0.009), especially in patients over 60 years old (OR 0.147, 95% confidence interval 0.026 - 0.822, p = 0.029).
 Conclusion: This study demonstrates that using enoxaparin significantly reduces the incidence of DVT in patients undergoing hip replacement, especially in patients over 60 years old.

Highlights

  • Our research aims to evaluate the effectiveness of thromboprophylaxis using enoxaparin in patients undergoing hip replacement

  • The predominant causes leading to hip replacement surgery included femoral neck fracture (83.8%) and hip degeneration (16.2%)

  • A total of 16 patients developed symptoms of deep venous thrombosis (DVT), of which 14 were diagnosed with DVT based on a positive result for thrombosis by venous Doppler ultrasound

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Summary

INTRODUCTION

Venous thromboembolism (VTE) is currently a threat to surgical patients and a burden to health care systems around the world. There have been many international studies showing the effectiveness of VTE prophylaxis in patients undergoing hip replacement surgery. At Thong Nhat Hospital, the prevention of VTE with low molecular weight heparin (enoxaparin) for hip replacement surgery patients has recently been implemented. The study was conducted based on medical records of patients aged 40 and older who had hip replacement surgery at Thong Nhat Hospital from January 2014 to January 2017. Information was obtained on patient characteristics (age, gender, weight, height, length of hospital stay, reasons for admission, medical history, and allergy history), surgical characteristics (cause, surgical choice, length of surgery, and presence or absence of indication of VTE prophylaxis with enoxaparin), and postoperative follow-up (clinical signs of DVT, PE, and subclinical tests). P-value < 0.05 was considered to represent a statistically significant difference

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