The effectiveness and safety of rivaroxaban versus low molecular weight heparin calcium on preventing postoperative lower extremity deep vein thrombosis in elderly patients with hip fracture

Objective To compare the preventive effect of rivaroxaban versus low molecular weight heparin calcium(LMWH)for lower extremity deep vein thrombosis(DVT)and evaluate the effectiveness and safety in the prevention post operative DVT in elderly patients with hip fracture.Methods From December 2009 to August 2011,128 elderly patients with hip fracture receiving hip operation were selected and randomized to gender-,age-,and operation type-matched two groups(n=64,each):rivaroxaban group and LMWH group.Beginning at 6 h post operation,anticoagulants were used in both two groups:rivaroxaban(in rivaroxaban group)10 mg once a day for three weeks by oral medication;LMWH(in LMWH group)4 100 U once a day for three weeks by hypodermic injection.The incidence of DVT and pulmonary embolism(PE),the postoperative drainage volume and bleeding volume were compared between two groups.Results The incidences of postoperative DVT in the operation of dynamic hip screw(DHS),artificial head replacement and total hip arthroplasty were 16.1%,11.1% and 20.0% respectively in rivaroxaban group,and that of the LMWH group were 12.9%,15.0% and 26.1%,respectively.There was no significant difference between two groups(all P0.05).No PE occurred after operation in all the patients.There was no significant difference in the drainage volume and bleeding volume of perioperative period between two groups.At the eighth day after artificial head replacement,big hematoma at wound place occurred only in one case in rivaroxaban group,and no other abnormalities were found.Conclusion Both rivaroxaban and LMWH can effectively prevent lower extremity DVT after hip fractures operation,which show an equivalent efficacy and have a similar safety at 6 h post operation,but oral rivaroxaban is more convenient and has a good patient compliance.