In a prospective studie 129 patients with hip fracture surgery under LDH-prophylaxis (3x5000 U Na-heparinat) were examined in order to find an answer tothe question, if there is a correlation between inhibitor activity, parameters of fibrinolysis, plasma heparin activity and the incidence of DVT.100 patients with ascending phlebography on day 7 to9 post op. were taken into final consideration (blood collection on admission and on day 1, 2, 4, 7 after surgery):1)Incidence of DVT : 17 %.2)Inhibitors: No difference between patients with and without DVT with respect to AT III activity and prot. C concentration ( prot. C activity in progress).3)Fibrinolysis: Elevated levels of DD-fragment (x = 1 780 mg/ml), t-PA Inhibitor (x = 31 AU) and fibrinogen (417 rng/dl) before operation due to preceding trauma. No significant difference between t-PA, t-PA inhibitor and antiplasmin with respect to DVT. Whileplasminogen concent was significantly increased in patients with DVT on day 4 and 7, DD-fragments had lower values on day 7 (x = 1395 / x = 2140 ng/ml).4)Heparin effect: Plasma heparin activity was assesed by an amidolytic anti ll^assay. Although plasmaticheparin action only represents one aspect of thromboprophylactic heparin-activity, there is an obvious difference between patients with and without DVT withrespect to plasmatic heparin activity( p <0.005).
Bleeding and first-year mortality following hip fracture surgery and preoperative use of low-dose acetylsalicylic acid: an observational cohort study