Biomaterial Database

[Perioperative prevention of thromboembolism with standard heparin and low molecular weight heparin, evaluation of postoperative hemorrhage. A double-blind, prospective, randomized and mono-center study]. 1992

R Hoffmann, and F Largiadèr

Departement Chirurgie, Universitätsspital, Zürich.

From October 1987 through June 1988 594 patients admitted to the department of visceral surgery, were included in a prospective, randomized double-blind study dealing with postoperative thromboembolic complications. 5000 I.U. heparin were administered twice daily to one group, the other group received a single dose of low molecular heparin (3000 I.U. anti-Xa) daily. In each group more than 290 patients were included. Diagnostic screening was done using LCCT (Liquid Crystal Contact Thermography) and phlebography. 130 patients had to be excluded from the study. 66 patients because of contra-indication, 54 patients because of administrative failing and 10 patients were excluded by the surgeon himself. There was no significant difference between the two groups concerning thromboembolic complications. However analysis of the patients who were excluded from the study shows an increase of thromboembolic complications. Looking at cases of postoperative haemorrhage we found that there was no significant difference between both groups. Interestingly, even compared to the excluded group, there was no difference. In our study postoperative haemorrhagic complications did not depend on the method of prophylaxis but on the surgeon performing the operation. Should a patient have a contra-indication for administration of thromboembolic prophylaxis, he has to take a certain risk of thrombosis. The fact that prophylaxis was not initiated because of neglect or fear of haemorrhagic complications is not only unforgiveable, but dangerous as well.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D011655	Pulmonary Embolism	Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.	Pulmonary Thromboembolism,Thromboembolism, Pulmonary,Embolism, Pulmonary,Embolisms, Pulmonary,Pulmonary Embolisms,Pulmonary Thromboembolisms,Thromboembolisms, Pulmonary
D004311	Double-Blind Method	A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.	Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260	Female		Females
D006470	Hemorrhage	Bleeding or escape of blood from a vessel.	Bleeding,Hemorrhages
D006493	Heparin	A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.	Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006495	Heparin, Low-Molecular-Weight	Heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism.	LMWH,Low-Molecular-Weight Heparin,Low Molecular Weight Heparin,Heparin, Low Molecular Weight

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