ArticleJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2022
Comparing Venous Thromboembolism Prophylactic Agents After Hip Fracture Surgery: A National Database Study.
Article in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Estrogen hormonal therapy is not associated with increased risk of venous thrombosis in total hip arthroplasty or hemiarthroplasty for femoral neck fractures.OTA international : the open access journal of orthopaedic trauma · 2026Article
- High mortality rates after distal femur fractures in patients with end-stage renal disease.OTA international : the open access journal of orthopaedic trauma · 2025Article
- Femoral Neck Fractures: Incidence, Reasons, and Risk Factors of Conversion From Hemiarthroplasty to Total Hip Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Predictors of Venous Thromboembolism Following Geriatric Distal Femur Fracture Fixation: Are These Patients at Higher Risk Compared With Hip Fracture Patients?Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
introductionAlthough the use of venous thromboembolism (VTE) chemoprophylaxis has markedly reduced VTE rates after hip fracture surgery, few studies have directly compared the efficacy of different anticoagulant agents in this setting. The purpose of this study was to compare outcomes of Lovenox, Eliquis, or Coumadin as VTE prophylaxis after hip fracture surgery.
methodsThe PearlDiver MHip national database was queried for patients older than 60 years undergoing first-time hip fracture surgery with no concurrent pelvic or distal femoral fractures. Prescriptions for Lovenox, Eliquis, or Coumadin were identified. Univariate and multivariate analyses of patient characteristics, 90-day incidences of VTE, adverse events, and readmissions were compared. Odds ratios (ORs) were calculated, and significance was set at P < 0.01 based on Bonferroni adjustment.
resultsA total of 11,384 patients were identified, with the Lovenox used for 6835 patients (60.0%), Eliquis for 1092 patients (9.6%), and Coumadin for 3457 patients (30.4%). The prevalence of 90-day VTE in the Lovenox, Eliquis, and Coumadin groups was 3.1%, 3.8%, and 5.0%, respectively (P < 0.001). Multivariate analyses adjusting for demographic and comorbidity profiles were conducted with Lovenox as the referent. Those on Eliquis had significantly lower transfusions (OR 0.52, P = 0.005), but similar rates of other outcomes including VTE (P > 0.01). Conversely, patients on Coumadin had significantly greater odds of any adverse event (OR 1.18, P < 0.001) and VTE (OR 1.58, P < 0.001). DISCUSSION: In evaluating Lovenox, Eliquis, and Coumadin as VTE chemoprophylactic agents after hip fracture surgery in anticoagulant-naïve patients, Lovenox and Eliquis had similar 90-day VTE, whereas patients on Coumadin had greater odds of 90-day VTE. Interestingly, patients on Eliquis had nearly two-fold lower odds of transfusions compared with patients on Lovenox. Although consensus on the optimal VTE prophylactic agent after hip fracture surgery does not exist, Eliquis and Lovenox may be comparable options and seem to be more effective than Coumadin.
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