Clinical observation of different course duration of rivaroxaban in preventing deep venous thrombosis after artificial femoral head replacement in elderly patients with femoral neck fracture / 中华创伤杂志

ABSTRACT

Objective To investigate the efficacy and safety of different course duration of rivaroxaban for deep venous thrombosis (DVT) in elderly patients with femoral neck fractures after artificial femoral head replacement.Methods A prospective case control study was conducted on 95 elderly cases of femoral neck fractures treated from February 2015 to July 2017.There were 18 males and 77 females,with average age of 80.8 years (range,70-98 years).There were 85 patients at stage Ⅲ and 10 at stage Ⅳ according to Garden classification.All patients received artificial femoral head replacement and were randomly divided into 3 groups (Group A34 cases,rivaroxaban treatment for 2 weeks;Group B31 cases,rivaroxaban treatment for 3 weeks;Group C30 cases,rivaroxaban treatment for 5 weeks).At 2,3 and 5 weeks after operation,the patients were given 10 mg oral rivaroxaban once daily.General information,blood transfusion rate,hemoglobin volume,platelet count and DVT rate were recorded before and 6 weeks after operation.Results No significant difference among the groups in terms of division,age,body mass index,fracture classification,time interval from injury,intraoperative blood loss,quantity of drainage fluid after operation,and associated underlying diseases was observed (P ＞ 0.05).The blood transfusion rate of Groups A,B and C within 2 weeks after operation was 9％ (3/34),3％ (1/31) and 3％ (1/30) (P ＞ 0.05) respectively.The comparative difference in hemoglobin and platelet count had no statistical significance (P ＞ 0.05).The DTV rate after operation of Groups A,B and C was 21％ (7/34),13％ (4/31) and 0,respectively.There was no significant difference between Groups B and C (P ＞ 0.05),but the difference between Groups A and C was statistically significant (P ＜ 0.05).Conclusions For elderly patients with femoral neck fracture who underwent the artificial femoral head replacement,it is effective to prevent the occurrence of DVT by extending the course of rivaroxaban treatment to 5 weeks.In addition,it does not increase the risk of bleeding.