Routine use of adjusted low-dose oral anticoagulants during the first three postoperative months after hip fracture in patients without comorbidity factors.

Abstract

This study reports the efficacy of adjusted low-dose oral anticoagulants in the prevention of fatal pulmonary embolism after hip fracture. Consecutive clinical study. Five hundred patients with hip fracture received oral anticoagulants as exclusive treatment. These patients were considered preoperatively not to have an increased risk for the development of postoperative pulmonary embolism; they had no poorly controlled systemic illness and were followed-up for at least three months. The average age was seventy-four years (range, 65-80). Anticoagulant therapy was begun on the evening of the operation and continued for three months. The dose was adjusted to keep the prothrombin time between seventeen and twenty seconds. Neither phlebography, sonography, nor lung scan was done routinely. Among the 500 patients, 476 continued to take low-dose oral anticoagulant for three months after the operation. Eight pulmonary embolisms were observed, but none was fatal. Only one patient developed a postoperative hematoma requiring surgical reoperation. In the absence of poorly controlled systemic illness, low-dose oral anticoagulants can be used after hip fracture.