Imran A Ali1,2, Husam Elbana3, Munthir Farhan3, Idris Ford Qureshi4, Ahmed Mubashir4. 1. Doncaster and Bassetlaw Teaching Hospitals, Kilton Hill, Nottinghamshire, S81 0BD, UK. Imran_itm@yahoo.co.uk. 2. Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Ashton Road, Lancaster, LA1 0RP, UK. Imran_itm@yahoo.co.uk. 3. Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Ashton Road, Lancaster, LA1 0RP, UK. 4. Doncaster and Bassetlaw Teaching Hospitals, Kilton Hill, Nottinghamshire, S81 0BD, UK.
Abstract
INTRODUCTION: Several studies have shown a reduction in the rate of thromboembolic events with LMWH thromboprophylaxis in patients immobilised in lower limb cast. However, the literature is limited on the use of rivaroxaban in this setting. Therefore the aim of this study was to assess the associated impact of rivaroxaban on the incidence of venous thromboembolism in trauma patients with lower limb cast immobilisation. METHOD: Adult patients treated with lower limb cast immobilisation for different types of lower limb injuries were included in this study. One cohort of patients (n = 518) received rivaroxaban thromboprophylaxis. This was compared with a historical cohort (n = 486), who received no rivaroxaban for thromboprophylaxis. RESULTS: The number of patients developing VTEs in the rivaroxaban group was zero, compared with 6 cases (1.2%) in the nonrivaroxaban group p = 0.013. There were no major or minor bleeding incidences; no wound complications reported in the rivaroxaban group. All the side effects reported in association with rivaroxaban use did not require further intervention. CONCLUSION: This study has shown that rivaroxaban is associated with a significant reduction in the risk of VTEs in patients with lower limb cast immobilisation without increasing the risk of bleeding or associated untoward effect. Lower limb immobilisation is high risk factor for VTE per se. However, there is still limited data in the literature to make further recommendations.
INTRODUCTION: Several studies have shown a reduction in the rate of thromboembolic events with LMWH thromboprophylaxis in patients immobilised in lower limb cast. However, the literature is limited on the use of rivaroxaban in this setting. Therefore the aim of this study was to assess the associated impact of rivaroxaban on the incidence of venous thromboembolism in traumapatients with lower limb cast immobilisation. METHOD: Adult patients treated with lower limb cast immobilisation for different types of lower limb injuries were included in this study. One cohort of patients (n = 518) received rivaroxaban thromboprophylaxis. This was compared with a historical cohort (n = 486), who received no rivaroxaban for thromboprophylaxis. RESULTS: The number of patients developing VTEs in the rivaroxaban group was zero, compared with 6 cases (1.2%) in the nonrivaroxaban group p = 0.013. There were no major or minor bleeding incidences; no wound complications reported in the rivaroxaban group. All the side effects reported in association with rivaroxaban use did not require further intervention. CONCLUSION: This study has shown that rivaroxaban is associated with a significant reduction in the risk of VTEs in patients with lower limb cast immobilisation without increasing the risk of bleeding or associated untoward effect. Lower limb immobilisation is high risk factor for VTE per se. However, there is still limited data in the literature to make further recommendations.
Authors: Aniek Ag Zee; Kelly van Lieshout; Maaike van der Heide; Loes Janssen; Heinrich Mj Janzing Journal: Cochrane Database Syst Rev Date: 2017-08-06