Keywords : Deep vein thrombosis
A Comparative Study on Benefit Risk Analysis of Deep Venous Thrombosis Prophylaxis with and Without Enoxaparin among Patients with Proximal Femoral Fractures
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 5759-5771
Background: The incidence of DVT in traumatic injuries is as high as 5-63%. An autopsy study found 20% death of PE and 65% of fatality of injured patients by DVT. Proximal femoral fracture are at a high risk of perioperative DVT and guidelines have recommended mechanical and pharmacological prophylaxis for patients undergoing surgery for hip fracture. But it remains controversial whether patients with proximal femoral fracture can benefit from thromboprophylaxis specially in Indian population. Our aim is to find out the role of enoxaparin in thromboprophylaxis, its adverse effects and surgery on different time span from date of injury on incidence of DVT.
Materials and Methods: Two arm observational study done on 100 patients presenting with proximal femur fracture above age of 40 years of either sex. Enoxaparin was given to group A and no pharmacological prophylaxis to group B. All patients were managed by anatomical reduction and fixation aiming to osteosynthesis. Serial colour doppler were done on admission and in postoperative (5th,7th)days and during follow up(1st,2nd,3rd) months.
Results: out of 100 patients, most patients were 71-80 years old [28 (28.0%)]. 15 (30.0%) patients were 51-60 years of age in Group-A and 15 (30.0%) patients were 71-80 years of age in Group-B. Male population [61 (61.0%)] was higher than the female population [39 (39.0%)]. Normal Colour doppler finding at 5th Post-op Day was equal in both Group A and Group B [49 (98.0%)]. Cumulative incidence of DVT at 3month follow up were in Group A = 6% and in Group B = 8% which was not statistically significant. (P = 0.6966). 2 patients had headache and 1 patient had wound sokage in group A.
Conclusion: Routine thromboprophylaxis is not recommended in Indian patients with proximal femur fractures. Further studies needed regarding genetic, racial and ethnic effect in these patients.