Chemoprophylaxis in lower limb immobilization : A systematic review and meta-analysis

Keywords:

Trauma ; Lower extremity ; Anticoagulants ; Thromboembolism


Published online: Feb 09 2021

Monil Karia, Sarah Onida, Prashant Singh, Akib Khan, Alun H. Davies

From the Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, Room, Charing Cross Hospital, London, United Kingdom

Abstract

The aim of this systematic review and meta-analysis is to review the effectiveness of low molecular weight heparin (LMWH) and novel oral anticoagulants (NOACs) for thromboprophylaxis in trauma patients treated with lower limb immobilisation.

All randomized controlled trials (RCTs) comparing thromboprophylaxis to no prophylaxis or standard for prevention of VTE in patients with lower limb trauma treated with immobilisation were included. Eight studies totaling 3190 patients were included.

The overall incidence of thromboembolic events in the control group ranged from 2.3% to 40% (137/871) and from 0% to 37% (77/884) in the LMWH group (RR 0.57; 95% CI = 0.45 to 0.73), P < 0.00001. One cohort study demonstrated equivalence of NOACs in VTE rate to LMWH with another demonstrating a significant reduction in VTE rates.

Our results demonstrate that LWMH is an effective agent in reducing DVT in these patients with an acceptable safety profile.

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About this issue

Volume 86, e-supplement 2.

Jun 2020.

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