Favorable coagulation profile with fondaparinux after hip surgery in elderly patients
Language English Country Japan Media print-electronic
Document type Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
PubMed
19838769
DOI
10.1007/s12185-009-0425-z
PII: 10.1007/s12185-009-0425-z
Knihovny.cz E-resources
- MeSH
- Anticoagulants administration & dosage therapeutic use MeSH
- Time Factors MeSH
- Fondaparinux MeSH
- Hip Fractures blood surgery MeSH
- Blood Coagulation drug effects MeSH
- Factor Xa Inhibitors * MeSH
- Injections, Subcutaneous MeSH
- Humans MeSH
- Inflammation Mediators blood MeSH
- Polysaccharides administration & dosage therapeutic use MeSH
- Postoperative Complications prevention & control MeSH
- Acute-Phase Proteins analysis MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Blood Coagulation Tests MeSH
- Venous Thromboembolism prevention & control MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Anticoagulants MeSH
- Fondaparinux MeSH
- Factor Xa Inhibitors * MeSH
- Inflammation Mediators MeSH
- Polysaccharides MeSH
- Acute-Phase Proteins MeSH
Twenty-three patients with fondaparinux prophylaxis over 75 years of age who underwent hip fracture surgery were enrolled in the study. Fondaparinux sodium (2.5 mg) was administered subcutaneously 6 h postoperatively and then every 24 h for 28 days. Coagulation and inflammatory parameters were measured preoperatively, then 10 h, 2, 7, and 28 days postoperatively. Increased D-dimers, positive acute phase proteins, and IL-6, and decreased negative acute phase proteins were observed preoperatively (P < 0.05). Maximum values were reached 10 h postoperatively for IL-6 and D-dimer, and on postoperative days 2 and 7 for positive acute phase proteins (P < 0.05). Transferrin, prealbumin and antithrombin levels were lowest 10 h postoperatively and on postoperative day 2 (P < 0.05). Increased D-dimers, IL-6, and positive acute phase proteins, and decreased negative acute phase proteins persisted until postoperative day 28 (P < 0.05). Prothrombin fragments (F1 + 2) reached peak levels preoperatively and decreased gradually until postoperative day 28. Fondaparinux promoted the inhibition of thrombin generation, as documented by negative correlation between F1 + 2 and FXa inhibition (r = -0.46; P < 0.001). Fondaparinux-induced FXa inhibition increased gradually until postoperative day 28. This increase correlated positively with antithrombin activity (r = 0.4; P < 0.05). Fondaparinux prophylaxis counteracted pro-thrombogenic effect associated with hip fracture and subsequent surgery without severe bleeding complications.
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