Session Time: 12:45pm-1:45pm
Disclosures: Ameer Ali, DO: No financial relationships or conflicts of interest
Objective: Compare the incidence of DVT in hip fracture patients on various chemoprophylactic agents. The goal of this study would be to determine if Aspirin is sufficient for preventing a DVT.
Design: Data points gathered included age, gender, type of hip fracture, method of hip fracture repair, and anticoagulant agent. To adequate power, the anticoagulants were classified into Aspirin (Group 1), Heparins (Group 2), and Novel Oral anticoagulants (NOAC) or Warfarin (Group 3). Setting : The study was conducted at Mercy Medical Center Acute Inpatient Rehabilitation Facility in Rockville Centre, New York. Participants : All patients (N=157) with Hip fractures status-post operative repair between July 2017 to July 2019.
Interventions: Patients on aspirin were examined with a weekly scheduled lower extremity venous Doppler.
Main Outcome Measures: Incidence of a DVT with respect to the anticoagulant agent used.
Results: The frequencies for initial dosage of anticoagulation were 22.3%, 52.9%, and 24.8 % with Aspirin, Heparins, and Novel Oral Anticoagulants/Warfarin respectively. The frequency of deep venous thrombosis was 9.6% overall in this patient population. 25.7% of patients on Aspirin developed a DVT. This is compared to 6% of patients on Heparins, and 2.6% of patients on NOAC/warfarin. Hence, the frequency of patients developing a DVT on aspirin is significantly higher compared to heparin or NOAC’s/warfarin. A chi-square test of independence was performed to examine the relationship between initial dosage of AC and DVT. The relationship between these variables was significant, X2 (2, N =157) = 13.98, p < . 001. Conclusions: Based on these results, patients treated with aspirin have a higher incidence of DVT. 25.7% of patients on Aspirin developed a DVT, compared to 6% on heparin, and 2.6% on NOAC/coumadin. We refute the recommendations by various articles claiming aspirin as one of the most effective methods for DVT prophylaxis. These findings represent the importance of sufficient thromboprophylaxis to prevent potentially fatal pulmonary emboli.
Level of Evidence: Level II
To cite this abstract in AMA style:Ali A, Mavretich B, Johnson CA. A Retrospective Review of Chemoprophylaxis for Deep Venous Thrombosis (DVT) in Post-Operative Hip Fracture Patients During Acute Inpatient Rehabilitation [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/a-retrospective-review-of-chemoprophylaxis-for-deep-venous-thrombosis-dvt-in-post-operative-hip-fracture-patients-during-acute-inpatient-rehabilitation/. Accessed October 23, 2021.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-retrospective-review-of-chemoprophylaxis-for-deep-venous-thrombosis-dvt-in-post-operative-hip-fracture-patients-during-acute-inpatient-rehabilitation/