Author(s): Abad JI, GmezOutes A, MartnezGonzlez J, Rocha E Bemiparin Ho
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Abstract INTRODUCTION: Bemiparin has shown to be effective and safe in clinical trials in total knee or hip replacement. MATERIALS AND METHODS: We conducted a prospective, open, multicentre, uncontrolled study to audit the utilisation patterns of bemiparin 3,500 IU/day, first dose administered 6 h after surgery, in 1,009 patients undergoing total hip or knee replacement surgery in standard clinical practice. We analysed rates of documented symptomatic venous thromboembolism (VTE) [deep-vein thrombosis (DVT) and pulmonary embolism (PE)] confirmed by objective methods, major bleeding, death, thrombocytopaenia and other adverse events up to 6 weeks. RESULTS: Rate of documented symptomatic DVT was 0.3\% (95\% CI, 0.1-0.9\%). No cases of documented PE were reported. There were 14 (1.4\%) major bleedings (95\% CI, 0.8-2.3\%). Neuraxial anaesthesia was used in 937 (92.9\%) patients. There were no cases of spinal haematoma, fatal bleeding or bleeding in critical organs. There were 6 (0.6\%) cases of mild thrombocytopaenia, which did not require treatment discontinuation. No cases of severe type II heparin-induced thrombocytopaenia were observed. There were no deaths during bemiparin prophylaxis. The median length of hospitalisation was 9 days and 92.5\% of patients continued prophylaxis post-hospitalisation for a total median time of 38 days. There were no thromboembolic or bleeding complications during post-hospitalisation prophylaxis. Postoperative start of prophylaxis with bemiparin permitted that 29.3\% of patients could be admitted to hospital the same day of the intervention. CONCLUSION: Bemiparin prophylaxis, started 6 h after surgery and given for 5-6 weeks after total hip or knee replacement, was associated with low rates of VTE, major bleeding and other adverse events in normal clinical practice. Bemiparin thromboprophylaxis started 6 h after surgery makes neuraxial anaesthesia/analgesia procedures easier, without compromising efficacy.
This article was published in Arch Orthop Trauma Surg
and referenced in Orthopedic & Muscular System: Current Research