Utilización de dabigatrán etexilato en postoperatorios traumatológicos de adultos mayores en un sistema de hospitalización a domicilio

Abstract

IntroductionHip replacement surgery (HRS) and knee replacement surgery (KRS) require long-term deep venous thrombosis (DVT) prophylaxis. This study describes dabigatran etexilate (DE) use in post-surgical older adults who underwent HRS and KRS in a clinical practice setting in a home-care system. Material and methodsA retrospective descriptive cohort study included elective HRS and KRS postsurgical older adults under home care receiving either DE (n=76) or enoxaparin (n=80). DE was indicated by using the same selection criteria and dosing as in the RE-MODEL and RE-NOVATE studies. The enoxaparin 40mg/day patients were included as historic controls when they met the same selection criteria as DE patients. Symptomatic DVT, bleeding rate, re-admission rate and mortality during the 90-day postsurgical period were analyzed. ResultsThe mean age of the DE group was 74 (5) years old, with 74% females. There were no significant differences in age, gender and type of replacement between the two groups. There were four DVT in each group (50% proximal), with no significant differences found between groups. There was one pulmonary thromboembolism in the DE group, and one major bleeding in the enoxaparin group. There were no deaths during the 90-day follow-up; however, two re-hospitalizations occurred in the DE group. The details on introducing DE use in our home-care system are also described. ConclusionsIn appropriately selected older adults DE seems to be an effective choice for DVT prophylaxis in home-care in a clinical practice setting.