High incidence of complications from enoxaparin treatment after arthroplasty

Andrew S. Neviaser, Charles Chang, Leonard Lyman Stephen, Alejandro Gonzales Della Valle, Steven B. Haas

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Pulmonary embolism (PE) complicates 1% to 10% of total joint arthroplasties and generally requires immediate anticoagulation. Low-molecular-weight heparins have supplanted unfractionated heparin as the treatment of choice for PE and hold a 1A recommendation from the American College of Chest Physicians for this indication. However, the complications of enoxaparin treatment begun in close proximity to arthroplasty surgery are not well described. We examined the records of 135 patients who underwent total joint arthroplasty, experienced an in-hospital PE, and received treatment with enoxaparin at therapeutic doses (1 mg/kg body weight). The type and frequency of complications were determined and classified as major or minor. Twenty-seven percent of patients experienced minor complications and 10% experienced major complications. The incidence of major bleeding was substantially higher than rates reported for nonsurgical patients. The overall complication rate of enoxaparin treatment is similar to the rate of complications reported for unfractionated heparin treatment in this setting, but the complications are less severe. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)115-119
Number of pages5
JournalClinical orthopaedics and related research
Volume468
Issue number1
DOIs
Publication statusPublished - Jan 1 2010
Externally publishedYes

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Enoxaparin
Arthroplasty
Incidence
Pulmonary Embolism
Therapeutics
Heparin
Joints
Low Molecular Weight Heparin
Body Weight
Guidelines
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

High incidence of complications from enoxaparin treatment after arthroplasty. / Neviaser, Andrew S.; Chang, Charles; Lyman Stephen, Leonard; Gonzales Della Valle, Alejandro; Haas, Steven B.

In: Clinical orthopaedics and related research, Vol. 468, No. 1, 01.01.2010, p. 115-119.

Research output: Contribution to journalArticle

Neviaser, Andrew S. ; Chang, Charles ; Lyman Stephen, Leonard ; Gonzales Della Valle, Alejandro ; Haas, Steven B. / High incidence of complications from enoxaparin treatment after arthroplasty. In: Clinical orthopaedics and related research. 2010 ; Vol. 468, No. 1. pp. 115-119.
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