Prevention of fatal pulmonary thromboembolism by heparin prophylaxis after surgery for hip fractures

Abstract

From 1960 through 1975, 337 patients with surgically treated acute fracture of the hip received subcutaneously administered heparin to prevent thromboembolic disease according to various regimens. Four hundred and three patients received no heparin. The incidence of fatal pulmonary embolism was 3.5 per cent in the 403 patients who reveived no heparin and 0.0 per cent in the 147 patients who were treated by the currently used regimen of prophylaxis, as follows: With the dose modified according to the coagulometer-test time, patients received 2,500 units on admission and every six hours until the day before operation. Then they were given 5,000 to 10,000 units eight to ten hours before surgery and 2,500 units every six hours after surgery until they were fully mobilized.