Skip to main content

Advertisement

SpringerLink
Log in

Venous thromboembolic prophylaxis for hip fractures

  • Review
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Patients with hip fractures are at very high risk for the development of venous thromboembolism (VTE). To provide an overview of cause, risk factors, current treatment strategies, and complications associated with VTE prophylaxis, we reviewed the most current, best available evidence on VTE prophylaxis for patients with hip fractures. We comprehensively reviewed the literature to assess the efficacy of VTE prophylaxis in patients with hip fractures, including the most recent published guidelines by national medical and surgical health organizations from the UK, USA, and Canada. Mechanical devices are effective in reducing the risk of VTE for hip fracture, but poor patient compliance is common and the devices are not recommended for sole VTE prophylaxis. Aspirin reduces the risk of VTE but does not provide optimal protection compared with other chemical agents; therefore, it is not recommended for sole VTE prophylaxis. Fondaparinux, warfarin, low-molecular-weight heparin, and unfractionated heparin reduce the risk of venographic deep vein thrombosis, but there is insufficient evidence that they reduce fatal pulmonary embolism or all-cause mortality. Fondaparinux is considered to be cost effective and more efficacious than low-molecular-weight heparin. At present, most major health organizations advocate at least 28 days of postoperative chemical prophylaxis. Chemical VTE prophylaxis should be administered to all patients with hip fractures unless contraindicated. Additional research is required to establish an agent that has a significant impact on fatal pulmonary embolism and all-cause mortality, without increasing bleeding complications, in this group of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jarvinen M (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805

    Article  PubMed  CAS  Google Scholar 

  2. Roberts SE, Goldacre MJ (2003) Time trends and demography of mortality after fractured neck of femur in an English population, 1968–98: database study. BMJ 327:771–775

    Article  PubMed  Google Scholar 

  3. McLaughlin MA, Orosz GM, Magaziner J, Hannan EL, McGinn T, Morrison RS, Hochman T, Koval K, Gilbert M, Siu AL (2006) Preoperative status and risk of complications in patients with hip fracture. J Gen Intern Med 21:219–225

    Article  PubMed  Google Scholar 

  4. Powers PJ, Gent M, Jay RM, Julian DH, Turpie AGG, Levine M, Hirsh J (1989) A randomized trial of less intense postoperative warfarin or aspirin therapy in the prevention of venous thromboembolism after surgery for fractured hip. Arch Intern Med 149:771–774

    Article  PubMed  CAS  Google Scholar 

  5. Agnelli G, Cosmi B, Di Filippo P, Ranucci V, Veschi F, Longetti M, Renga C, Barzi F, Gianese F, Lupattelli L (1992) A randomised, double-blind, placebo-controlled trial of dermatan sulphate for prevention of deep vein thrombosis in hip fracture. Thromb Haemost 67:203–208

    PubMed  CAS  Google Scholar 

  6. Hamilton HW, Crawford JS, Gardiner JH, Wiley AM (1970) Venous thrombosis in patients with fracture of the upper end of the femur. A phlebographic study of the effect of prophylactic anticoagulation. J Bone Joint Surg Br 52:268–289

    PubMed  CAS  Google Scholar 

  7. Rogers PH, Walsh PN, Marder VJ, Bosak GC, Lachman JW, Ritchie WGM, Oppenheimer L, Sherry S (1978) Controlled trial of low-dose heparin and sulfinpyrazone to prevent venous thromboembolism after operation on the hip. J Bone Joint Surg Am 60:758–762

    PubMed  CAS  Google Scholar 

  8. Jorgensen PS, Strandberg C, Willie-Jorgensen P, Torholm C, Neergaard K, Paaske BP, Rasmussen SW, Christensen SW, Martoni M, Thamsen H (1998) Early preoperative thromboprophylaxis with Klexane in hip fracture study: a placebo-controlled study. Clin Appl Thromb Hemost 4:140–142

    Article  Google Scholar 

  9. Rosencher N, Vielpeau C, Emmerich J, Fagnani F, Samama CM (2005) Venous thromboembolism and mortality after hip fracture surgery: the ESCORTE study. J Thromb Haemost 3:2006–2014

    Article  PubMed  CAS  Google Scholar 

  10. Perez JV, Warwick DJ, Case CP, Bannister GC (1995) Death after proximal femoral fracture—an autopsy study. Injury 26:237–240

    Article  PubMed  CAS  Google Scholar 

  11. Todd CJ, Freeman CJ, Camilleri-Ferrante C, Palmer CR, Hyder A, Laxton CE, Parker MJ, Payne BV, Rushton N (1995) Differences in mortality after fracture of hip: the east Anglian audit. BMJ 310:904–908

    PubMed  CAS  Google Scholar 

  12. Haake DA, Berkman SA (1989) Venous thromboembolic disease after hip surgery. Risk factors, prophylaxis, and diagnosis. Clin Orthop Relat Res 242:212–231

    PubMed  Google Scholar 

  13. Dahl OE, Caprini JA, Colwell CW Jr, Frostick SP, Haas S, Hull RD, Laporte S, Stein PD (2005) Fatal vascular outcomes following major orthopedic surgery. Thromb Haemost 93:860–866

    PubMed  CAS  Google Scholar 

  14. Haas S, Wolf H, Kakkar AK, Fareed J, Encke A (2005) Prevention of fatal pulmonary embolism and mortality in surgical patients: a randomized double-blind comparison of LMWH with unfractionated heparin. Thromb Haemost 94:814–819

    PubMed  Google Scholar 

  15. Eriksson BI, Lassen MR, PENTasaccharide in HIp-FRActure Surgery Plus (PENTHIFRA Plus) Investigators (2003) Duration of prophylaxis against venous thromboembolism with fondaparinux after hip fracture surgery: a multicenter, randomized, placebo-controlled, double-blind study. Arch Intern Med 163:1337–1342

    Article  PubMed  CAS  Google Scholar 

  16. McNamara I, Sharma A, Prevost T, Parker M (2009) Symptomatic venous thromboembolism following a hip fracture: incidence and risk factors in 5,300 patients. Acta Orthop 80:687–691

    Article  PubMed  Google Scholar 

  17. Maynard MJ, Sculco TP, Ghelman B (1991) Progression and regression of deep vein thrombosis after total knee arthroplasty. Clin Orthop Relat Res 273:125–130

    PubMed  Google Scholar 

  18. White RH, Romano PS, Zhou H, Rodrigo J, Bargar W (1998) Incidence and time course of thromboembolic outcomes following total hip or knee arthroplasty. Arch Intern Med 158:1525–1531

    Article  PubMed  CAS  Google Scholar 

  19. Bjornara BT, Gudmundsen TE, Dahl OE (2006) Frequency and timing of clinical venous thromboembolism after major joint surgery. J Bone Joint Surg Br 88:386–391

    Article  PubMed  CAS  Google Scholar 

  20. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW (2008) Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133:381S–453S

    Article  PubMed  CAS  Google Scholar 

  21. Planes A, Vochelle N, Darmon JY, Fagola M, Bellaud M, Huet Y (1996) Risk of deep-venous thrombosis after hospital discharge in patients having undergone total hip replacement: double-blind randomised comparison of enoxaparin versus placebo. Lancet 348:224–228

    Article  PubMed  CAS  Google Scholar 

  22. Scottish Intercollegiate Guidelines Network (2009) Management of hip fracture in older people. Scottish Intercollegiate Guidelines Network, Edinburgh

    Google Scholar 

  23. National Institute for Health and Clinical Excellence (2010) Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital. Clinical Guideline 92. http://www.nice.org.uk/guidance/index.jsp?action=byID&o=12695. Accessed May 7

  24. American Academy of Orthopaedic Surgeons (2010) Prophylaxis: recommendations from the seventh ACCP conference on antithrombotic and thrombolytic therapy: hip fracture surgery. http://www5.aaos.org/dvt/physician/page.cfm?pageID=OKO_ADU013_P35&topic=ADU013. Accessed May 24

  25. British Orthopaedic Association (2007) The care of patients with fragility fracture. British Orthopaedic Association, London

    Google Scholar 

  26. Lundkvist J, Bergqvist D, Jonsson B (2007) Cost-effectiveness of extended prophylaxis with fondaparinux compared with low molecular weight heparin against venous thromboembolism in patients undergoing hip fracture surgery. Eur J Health Econ 8:313–323

    Article  PubMed  Google Scholar 

  27. Happe LE, Farrelly EM, Stanford RH, Sarnes MW (2008) Cost and occurrence of thrombocytopenia in patients receiving venous thromboembolism prophylaxis following major orthopaedic surgeries. J Thromb Thrombolysis 26:125–131

    Article  PubMed  Google Scholar 

  28. White RH (2003) The epidemiology of venous thromboembolism. Circulation 107:I-4–I-8

    Article  Google Scholar 

  29. Fisher CG, Blachut PA, Salvian AJ, Meek RN, O'Brien PJ (1995) Effectiveness of pneumatic leg compression devices for the prevention of thromboembolic disease in orthopaedic trauma patients: a prospective, randomized study of compression alone versus no prophylaxis. J Orthop Trauma 9:1–7

    Article  PubMed  CAS  Google Scholar 

  30. Mackman N (2004) Role of tissue factor in hemostasis, thrombosis, and vascular development. Arterioscler Thromb Vasc Biol 24:1015–1022

    Article  PubMed  CAS  Google Scholar 

  31. Comerota AJ, Stewart GJ, Alburger PD, Smalley K, White JV (1989) Operative venodilation: a previously unsuspected factor in the cause of postoperative deep vein thrombosis. Surgery 106:301–308, discussion 308–309

    PubMed  CAS  Google Scholar 

  32. Stamatakis JD, Kakkar VV, Sagar S, Lawrence D, Nairn D, Bentley PG (1977) Femoral vein thrombosis and total hip replacement. Br Med J 2:223–225

    Article  PubMed  CAS  Google Scholar 

  33. Mammen EF (1992) Pathogenesis of venous thrombosis. Chest 102:640S–644S

    PubMed  CAS  Google Scholar 

  34. Coleridge-Smith PD, Hasty JH, Scurr JH (1990) Venous stasis and vein lumen changes during surgery. Br J Surg 77:1055–1059

    Article  PubMed  CAS  Google Scholar 

  35. Caprini JA (2010) Risk assessment as a guide for the prevention of the many faces of venous thromboembolism. Am J Surg 199:S3–S10

    Article  PubMed  Google Scholar 

  36. White SM, Griffiths R, Holloway J, Shannon A (2010) Anaesthesia for proximal femoral fracture in the UK: first report from the NHS Hip Fracture Anaesthesia Network. Anaesthesia 65:243–248

    Article  PubMed  CAS  Google Scholar 

  37. Sorenson RM, Pace NL (1992) Anesthetic techniques during surgical repair of femoral neck fractures. A meta-analysis. Anesthesiology 77:1095–1104

    Article  PubMed  CAS  Google Scholar 

  38. Parker MJ, Handoll HHG, Griffiths R (2004) Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. doi:10.1002/14651858.CD000521.pub2, 4:CD000521

    Google Scholar 

  39. Anderson FA Jr, Spencer FA (2003) Risk factors for venous thromboembolism. Circulation 107:I-9–I-16

    Article  Google Scholar 

  40. Warkentin TE, Greinacher A (2004) Heparin-induced thrombocytopenia: recognition, treatment, and prevention. The seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126:311S–337S

    Article  PubMed  CAS  Google Scholar 

  41. Borow M, Goldson HJ (1983) Prevention of postoperative deep venous thrombosis and pulmonary emboli with combined modalities. Am Surg 49:599–605

    PubMed  CAS  Google Scholar 

  42. Schroder HM, Andreassen M (1993) Autopsy-verified major pulmonary embolism after hip fracture. Clin Orthop Relat Res 293:196–203

    PubMed  Google Scholar 

  43. Hefley WF Jr, Nelson CL, Puskarich-May CL (1996) Effect of delayed admission to the hospital on the preoperative prevalence of deep-vein thrombosis associated with fractures about the hip. J Bone Joint Surg Am 78:581–583

    PubMed  Google Scholar 

  44. Zahn HR, Skinner JA, Porteous MJ (1999) The preoperative prevalence of deep vein thrombosis in patients with femoral neck fractures and delayed operation. Injury 30:605–607

    Article  PubMed  CAS  Google Scholar 

  45. The Thrombosis Interest Group of Canada (2010) VTE prophylaxis in major orthopedic surgery. http://www.tigc.org/eguidelines/VTE-ProphylaxisOrthopedicSurgery.htm. Accessed May 13

  46. Cohen AT, Skinner JA, Warwick D, Brenkel I (2007) The use of graduated compression stockings in association with fondaparinux in surgery of the hip. A multicentre, multinational, randomised, open-label, parallel-group comparative study. J Bone Joint Surg Br 89:887–892

    Article  PubMed  CAS  Google Scholar 

  47. Eriksson BI, Bauer KA, Lassen MR, Turpie AGG, Steering Committee of the Pentasaccharide in Hip-Fracture Surgery Study (2001) Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery. N Engl J Med 345:1298–1304

    Article  PubMed  CAS  Google Scholar 

  48. Pulmonary Embolism Prevention (PEP) Trial Collaborative Group (2000) Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet 355:1295–1302

    Article  Google Scholar 

  49. Sasaki S, Miyakoshi N, Matsuura H, Saitoh H, Kudoh D, Shimada Y (2009) Prospective randomized controlled trial on the effect of fondaparinux sodium for prevention of venous thromboembolism after hip fracture surgery. J Orthop Sci 14:491–496

    Article  PubMed  CAS  Google Scholar 

  50. Lefaivre KA, Macadam SA, Davidson DJ, Gandhi R, Chan H, Broekhuyse HM (2009) Length of stay, mortality, morbidity and delay to surgery in hip fractures. J Bone Joint Surg Br 91:922–927

    Article  PubMed  CAS  Google Scholar 

  51. Shiga T, Wajima Z, Ohe Y (2008) Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression. Can J Anaesth 55:146–154

    Article  PubMed  Google Scholar 

  52. Moran CG, Wenn RT, Sikand M, Taylor AM (2005) Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am 87:483–489

    Article  PubMed  Google Scholar 

  53. Grimes JP, Gregory PM, Noveck H, Butler MS, Carson JL (2002) The effects of time-to-surgery on mortality and morbidity in patients following hip fracture. Am J Med 112:702–709

    Article  PubMed  Google Scholar 

  54. Orosz GM, Magaziner J, Hannan EL, Morrison RS, Koval K, Gilbert M, McLaughlin M, Halm EA, Wang JJ, Litke A, Silberzweig SB, Siu AL (2004) Association of timing of surgery for hip fracture and patient outcomes. JAMA 291:1738–1743

    Article  PubMed  CAS  Google Scholar 

  55. Handoll HHG, Farrar MJ, McBirnie J, Tytherleigh-Strong G, Milne AA, Gillespie WJ (2002) Heparin, low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures. Cochrane Database Syst Rev. doi:10.1002/14651858.CD000305, 4:CD000305

    Google Scholar 

  56. Ohlund C, Fransson SG, Starck SA (1983) Calf compression for prevention of thromboembolism following hip surgery. Acta Orthop Scand 54:896–899

    Article  PubMed  CAS  Google Scholar 

  57. Fredin H, Bergqvist D, Cederholm C, Lindblad B, Nyman U (1989) Thromboprophylaxis in hip arthroplasty. Dextran with graded compression or preoperative dextran compared in 150 patients. Acta Orthop Scand 60:678–681

    Article  PubMed  CAS  Google Scholar 

  58. Cohen AT, Skinner JA, Kakkar VV (1994) Antiplatelet treatment for thromboprophylaxis: a step forward or backwards? BMJ 309:1213–1215

    PubMed  CAS  Google Scholar 

  59. Antiplatelet Trialists’ Collaboration (1994) Collaborative overview of randomised trials of antiplatelet therapy—III: reduction in venous thrombosis and pulmonary embolism by antiplatelet prophylaxis among surgical and medical patients. BMJ 308:235–246

    Google Scholar 

  60. McKenna R, Galante J, Bachmann F, Wallace DL, Kaushal SP, Meredith P (1980) Prevention of venous thromboembolism after total knee replacement by high-dose aspirin or intermittent calf and thigh compression. Br Med J 280:514–517

    Article  PubMed  CAS  Google Scholar 

  61. Westrich GH, Sculco TP (1996) Prophylaxis against deep venous thrombosis after total knee arthroplasty. Pneumatic plantar compression and aspirin compared with aspirin alone. J Bone Joint Surg Am 78:826–834

    PubMed  CAS  Google Scholar 

  62. Gent M, Hirsh J, Ginsberg JS, Powers PJ, Levine MN, Geerts WH, Jay RM, Leclerc J, Neemeh JA, Turpie AGG (1996) Low-molecular-weight heparinoid orgaran is more effective than aspirin in the prevention of venous thromboembolism after surgery for hip fracture. Circulation 93:80–84

    PubMed  CAS  Google Scholar 

  63. Monreal M, Lafoz E, Navarro A, Granero X, Caja V, Caceres E, Salvador R, Ruiz J (1989) A prospective double-blind trial of a low molecular weight heparin once daily compared with conventional low-dose heparin three times daily to prevent pulmonary embolism and venous thrombosis in patients with hip fracture. J Trauma 29:873–875

    Article  PubMed  CAS  Google Scholar 

  64. Barsotti J, Gruel Y, Rosset P, Favard L, Dabo B, Andreu J, Delahousse B, Leroy J (1990) Comparative double-blind study of two dosage regimens of low-molecular weight heparin in elderly patients with a fracture of the neck of the femur. J Orthop Trauma 4:371–375

    PubMed  CAS  Google Scholar 

  65. The TIFDED Study Group (1999) Thromboprophylaxis in hip fracture surgery: a pilot study comparing danaparoid, enoxaparin and dalteparin. Haemostasis 29:310–317

    Google Scholar 

  66. Keeling D, Davidson S, Watson H, Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology (2006) The management of heparin-induced thrombocytopenia. Br J Haematol 133:259–269

    Article  PubMed  CAS  Google Scholar 

  67. Sullivan SD, Kwong L, Nutescu E (2006) Cost-effectiveness of fondaparinux compared with enoxaparin as prophylaxis against venous thromboembolism in patients undergoing hip fracture surgery. Value Health 9:68–76

    Article  PubMed  Google Scholar 

  68. Muntz JE, Michota FA (2010) Prevention and management of venous thromboembolism in the surgical patient: options by surgery type and individual patient risk factors. Am J Surg 199:S11–S20

    Article  PubMed  CAS  Google Scholar 

  69. Kearon C, Hirsh J (1995) Starting prophylaxis for venous thromboembolism postoperatively. Arch Intern Med 155:366–372

    Article  PubMed  CAS  Google Scholar 

  70. Hull RD, Brant RF, Pineo GF, Stein PD, Raskob GE, Valentine KA (1999) Preoperative vs postoperative initiation of low-molecular-weight heparin prophylaxis against venous thromboembolism in patients undergoing elective hip replacement. Arch Intern Med 159:137–141

    Article  PubMed  CAS  Google Scholar 

  71. Hull RD, Pineo GF, Francis C, Bergqvist D, Fellenius C, Soderberg K, Holmqvist A, Mant M, Dear R, Baylis B, Mah A, Brant R, The North American Fragmin Trial Investigators (2000) Low-molecular-weight heparin prophylaxis using dalteparin in close proximity to surgery vs warfarin in hip arthroplasty patients: a double-blind, randomized comparison. Arch Intern Med 160:2199–2207

    Article  PubMed  CAS  Google Scholar 

  72. Strebel N, Prins M, Agnelli G, Buller HR (2002) Preoperative or postoperative start of prophylaxis for venous thromboembolism with low-molecular-weight heparin in elective hip surgery? Arch Intern Med 162:1451–1456

    Article  PubMed  CAS  Google Scholar 

  73. Raskob GE, Hirsh J (2003) Controversies in timing of the first dose of anticoagulant prophylaxis against venous thromboembolism after major orthopedic surgery. Chest 124:379S–385S

    Article  PubMed  Google Scholar 

  74. Turpie A, Bauer K, Eriksson B, Lassen M, Steering Committees of the Pentasaccharide Orthopedic Prophylaxis Studies (2003) Efficacy and safety of fondaparinux in major orthopedic surgery according to the timing of its first administration [letter to the editor]. Thromb Haemost 90:364–366

    PubMed  CAS  Google Scholar 

  75. Verlato F, Bruchi O, Prandoni P, Camporese G, Maso G, Busonera F, Girolami A, Andreozzi GM, Warfarin Optimal Duration Orthopaedic Study (WODOS) Investigators Group (2001) The value of ultrasound screening for proximal vein thrombosis after total hip arthroplasty: a prospective cohort study. Thromb Haemost 86:534–537

    PubMed  CAS  Google Scholar 

  76. Schmidt B, Michler R, Klein M, Faulmann G, Weber C, Schellong S (2003) Ultrasound screening for distal vein thrombosis is not beneficial after major orthopedic surgery. A randomized controlled trial. Thromb Haemost 90:949–954

    PubMed  CAS  Google Scholar 

  77. Thaler HW, Roller RE, Greiner N, Sim E, Korninger C (2001) Thromboprophylaxis with 60 mg enoxaparin is safe in hip trauma surgery. J Trauma 51:518–521

    Article  PubMed  CAS  Google Scholar 

  78. Bergqvist D, Jonsson B (1999) Cost-effectiveness of prolonged administration of a low molecular weight heparin for the prevention of deep venous thrombosis following total hip replacement. Value Health 2:288–294

    Article  PubMed  CAS  Google Scholar 

  79. Davies LM, Richardson GA, Cohen AT (2000) Economic evaluation of enoxaparin as postdischarge prophylaxis for deep vein thrombosis (DVT) in elective hip surgery. Value Health 3:397–406

    Article  PubMed  CAS  Google Scholar 

  80. Bjorvatn A, Kristiansen F (2005) Fondaparinux sodium compared with enoxaparin sodium: a cost-effectiveness analysis. Am J Cardiovasc Drugs 5:121–130

    Article  PubMed  CAS  Google Scholar 

  81. Dranitsaris G, Stumpo C, Smith R, Bartle W (2009) Extended dalteparin prophylaxis for venous thromboembolic events: cost-utility analysis in patients undergoing major orthopedic surgery. Am J Cardiovasc Drugs 9:45–58

    PubMed  Google Scholar 

  82. Schulman S, Beyth RJ, Kearon C, Levine MN (2008) Hemorrhagic complications of anticoagulant and thrombolytic treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133:257S–298S

    Article  PubMed  CAS  Google Scholar 

  83. Hull R, Hirsh J, Jay R, Carter C, England C, Gent M, Turpie AGG, McLoughlin D, Dodd P, Thomas M, Raskob G, Ockelford P (1982) Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. N Engl J Med 307:1676–1681

    Article  PubMed  CAS  Google Scholar 

  84. Linkins LA, Choi PT, Douketis JD (2003) Clinical impact of bleeding in patients taking oral anticoagulant therapy for venous thromboembolism: a meta-analysis. Ann Intern Med 139:893–900, E901

    PubMed  Google Scholar 

  85. Mismetti P, Laporte S, Zufferey P, Epinat M, Decousus H, Cucherat M (2004) Prevention of venous thromboembolism in orthopedic surgery with vitamin K antagonists: a meta-analysis. J Thromb Haemost 2:1058–1070

    Article  PubMed  CAS  Google Scholar 

  86. Kearon C, Ginsberg JS, Kovacs MJ, Anderson DR, Wells P, Julian JA, MacKinnon B, Weitz JI, Crowther MA, Dolan S, Turpie AG, Geerts W, Solymoss S, van Nguyen P, Demers C, Kahn SR, Kassis J, Rodger M, Hambleton J, Gent M, Extended Low-Intensity Anticoagulation for Thrombo-Embolism Investigators (2003) Comparison of low-intensity warfarin therapy with conventional-intensity warfarin therapy for long-term prevention of recurrent venous thromboembolism. N Engl J Med 349:631–639

    Article  PubMed  CAS  Google Scholar 

  87. Dolovich LR, Ginsberg JS, Douketis JD, Holbrook AM, Cheah G (2000) A meta-analysis comparing low-molecular-weight heparins with unfractionated heparin in the treatment of venous thromboembolism: examining some unanswered questions regarding location of treatment, product type, and dosing frequency. Arch Intern Med 160:181–188

    Article  PubMed  CAS  Google Scholar 

  88. Roche JJW, Wenn RT, Sahota O, Moran CG (2005) Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ 331:1374. doi:10.1136/bmj.38643.663843.55

    Article  PubMed  CAS  Google Scholar 

  89. Grand'Maison A, Charest AF, Geerts WH (2005) Anticoagulant use in patients with chronic renal impairment. Am J Cardiovasc Drugs 5:291–305

    Article  PubMed  Google Scholar 

  90. Thorevska N, Amoateng-Adjepong Y, Sabahi R, Schiopescu I, Salloum A, Muralidharan V, Manthous CA (2004) Anticoagulation in hospitalized patients with renal insufficiency: a comparison of bleeding rates with unfractionated heparin vs enoxaparin. Chest 125:856–863

    Article  PubMed  CAS  Google Scholar 

  91. Laposata M, Green D, Van Cott EM, Barrowcliffe TW, Goodnight SH, Sosolik RC (1998) College of American Pathologists Conference XXXI on laboratory monitoring of anticoagulant therapy: the clinical use and laboratory monitoring of low-molecular-weight heparin, danaparoid, hirudin and related compounds, and argatroban. Arch Pathol Lab Med 122:799–807

    PubMed  CAS  Google Scholar 

  92. Sharrock NE, Gonzalez Della Valle A, Go G, Lyman S, Salvati EA (2008) Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clin Orthop Relat Res 466:714–721

    Article  PubMed  Google Scholar 

  93. Novicoff WM, Brown TE, Cui Q, Mihalko WM, Slone HS, Saleh KJ (2008) Mandated venous thromboembolism prophylaxis: possible adverse outcomes. J Arthroplasty 23:15–19

    Article  PubMed  Google Scholar 

  94. Callaghan JJ, Dorr LD, Engh GA, Hanssen AD, Healy WL, Lachiewicz PF, Lonner JH, Lotke PA, Ranawat CS, Ritter MA, Salvati EA, Sculco TP, Thornhill TS (2005) Prophylaxis for thromboembolic disease: recommendations from the American College of Chest Physicians—are they appropriate for orthopaedic surgery? [editorial]. J Arthroplasty 20:273–274

    Article  PubMed  Google Scholar 

  95. Stein PD, Henry JW (1995) Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest 108:978–981

    Article  PubMed  CAS  Google Scholar 

  96. American Academy of Orthopaedic Surgeons (2007) Clinical guideline on prevention of pulmonary embolism in patients undergoing total hip or knee arthroplasty. American Academy of Orthopaedic Surgeons, Rosemont

    Google Scholar 

  97. Haas SB, Barrack RL, Westrich G, Lachiewicz PF (2008) Venous thromboembolic disease after total hip and knee arthroplasty. J Bone Joint Surg Am 90:2764–2780

    PubMed  Google Scholar 

  98. Moser KM, LeMoine JR (1981) Is embolic risk conditioned by location of deep venous thrombosis? Ann Intern Med 94:439–444

    PubMed  CAS  Google Scholar 

  99. Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J (2009) American Association of Orthopedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients? Chest 135:513–520

    Article  PubMed  Google Scholar 

  100. Kearon C (2003) Natural history of venous thromboembolism. Circulation 107:I-22–I-30

    Google Scholar 

Download references

Conflicts of interest

Dr. Stephen L. Kates is a speaker with Eli Lilly & Co. and has received a research grant from Synthes, Inc.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA

    D. Marsland

  2. Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA

    S. L. Kates

  3. Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A665, Baltimore, MD, 21224-2780, USA

    S. C. Mears

Authors
  1. D. Marsland
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. C. Mears
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. L. Kates
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. C. Mears.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marsland, D., Mears, S.C. & Kates, S.L. Venous thromboembolic prophylaxis for hip fractures. Osteoporos Int 21 (Suppl 4), 593–604 (2010). https://doi.org/10.1007/s00198-010-1403-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-010-1403-2

Keywords

Search

Navigation