Abstract
Background
Thromboembolism is a recognised preventable complication following lower limb immobilisation. This study evaluates an institution's experience of outpatient Venous Thromboembolism (VTE) prophylaxis using either Dalteparin administered subcutaneously or off-license Dabigatran orally in patients with lower limb injury requiring immobilisation.
Method
Group I consisted of 383 patients who were given either Dalteparin subcutaneously (239) or off-license Dabigatran (128) VTE prophylaxis orally following lower limb injury requiring immobilisation with 15 patients declined either option. Group II consisted of 679 patients that did not receive any thromboprophylaxis following lower limb injury requiring immobilisation. Clinical identifiable Pulmonary Embolism (PE) and Deep Vein Thrombosis (DVT) were extracted from the prospective VTE database and electronic patient records for Group I. While for Group II, this was information was obtained from patient’s records (retrospectively).
Results
There was no significant difference (Fisher's exact test) between Group I and Group II for DVT (0.168) and PE (0.284). The clinical PE and DVT incidence rate in Group I was 0.5 and 0 %, respectively, while in Group II, it was 0.1 and 0.7 %, respectively. One patient developed haemoptysis after Dabigatran was administered orally, and one patient had gastrointestinal bleeding after Dalteparin was given subcutaneously; no adverse medical harm came to either patient.
Conclusion
Although this study was unable to demonstrate, a statistically significant impact on VTE rates with prophylaxis, the protective role of prophylaxis is suggested by the low incidence of VTE in our study population, which is comparable to literature (20 %).
Level of Evidence: Therapeutic Level III
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Menakaya, C.U., Boddice, T., Malhotra, R. et al. Outpatients thromboprophylaxis following lower limb immobilisation: an institution’s experience. Eur Orthop Traumatol 5, 335–339 (2014). https://doi.org/10.1007/s12570-013-0240-0
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DOI: https://doi.org/10.1007/s12570-013-0240-0