ISSN 2997-1036
International Journal of Hematology | Vol. 3, No. 8, August 2012 | pp. 57–64
DOI: 10.46882/2012/IJH/000032
Original Article
Title: Efficacy and safety of standard-dose versus low-dose low-molecular-weight heparin for venous thromboembolism prophylaxis in orthopedic surgery
Names of Authors: G. M. Babalola¹, I. N. Nwosu², K. S. Abubakar³
Authors’ Affiliations: ¹Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria; ²Department of Orthopaedic Surgery, University of Nigeria, Nsukka, Nigeria; ³Department of Pathology, Bayero University, Kano, Nigeria
Abstract: Major orthopedic procedures carry an exceptionally high risk of deep vein thrombosis, requiring robust pharmacological prophylaxis. This randomized controlled trial compared the efficacy and safety of standard-dose enoxaparin (40 mg subcutaneously daily) versus a low-dose regimen (20 mg subcutaneously daily) in 140 adult patients undergoing total hip or knee arthroplasty. Prophylaxis was initiated 12 hours post-operatively and maintained for 14 days. Objective screening using venous duplex ultrasonography was performed on day 14. The incidence of deep vein thrombosis was 4.3% (3 of 70) in the standard-dose group and 11.4% (8 of 70) in the low-dose group (P = 0.12). However, major bleeding episodes, defined by a hemoglobin drop exceeding 2.0 g/dl or requiring transfusion, were significantly higher in the standard-dose cohort (7.1% versus 0.0% in the low-dose cohort, P < 0.05). Minor wound hematomas occurred in 15.7% of standard-dose patients. While standard-dose enoxaparin provides numerically superior antithrombotic protection, the low-dose regimen demonstrates a significantly reduced bleeding risk. Clinicians should carefully weigh individual bleeding risks against thrombotic factors when selecting prophylactic doses in indigenous orthopedic patients.
Keywords: Deep vein thrombosis, enoxaparin, thromboprophylaxis, arthroplasty, hemorrhage
Manuscript Timeline: Received: May 05, 2012; Revised: June 15, 2012; Accepted: July 02, 2012; Published: August 14, 2012