Chemoprophylaxis for deep vein thrombosis after hip surgery: The Indian prospective

Background: Deep vein thrombosis (DVT) or venous thromboembolism is a fatal complication of patients undergoing elective hip surgeries. Not much evidence is provided in the Indian literature regarding the incidence of DVT in the Indian population and ideal prophylaxis for the same. This issue has gained much importance in recent history due to the increase in a number of elective hip surgeries. Low-molecular-weight (LMW) heparin is commonly used for chemoprophylaxis against DVT. Our study is to identify the role of LMW heparin (enoxaparin) for prophylaxis against DVT. Materials and Methods: The present study is a prospective study for the role of enoxaparin in prophylaxis against DVT in patients of elective hip surgeries carried out over a period of 2 years. A total of 110 patients were selected based on the stringent inclusion and exclusion criteria. Randomization was done and patients were divided into two groups of 55 patients each. Group 1 (case) received postoperative enoxaparin at a dose of 40 mg subcutaneous daily for 7 days whereas Group 2 (control) did not receive any prophylaxis, following which color Doppler was performed on all patients. Results: The overall incidence of DVT in our study group was found to be 23.6%, of which 61.5% had distal thrombus and 28.5% had thrombus in the proximal vein. The incidence of DVT in case group was 12.5% compared to control group, in which the incidence of DVT was found to be 34.5%; hence, statistically significant difference (P = 0.0071) in the incidence of DVT was found in both groups. Duration of surgery and patient's age were two most significant risk factors associated with the occurrence of DVT. No statistically significant difference was noted regarding postoperative bleeding complications between two groups (P > 0.05). Conclusion: DVT/venous thromboembolism is relatively less common in Indian patients following elective hip surgeries as compared to the Western population, and LMW heparin is a safe and effective method of prophylaxis against DVT.