[ @entity882 after elective hip joint replacement with postoperative prevention of XXXX with low-molecular-weight heparin].

@entity1 @entity882 @entity1151 @entity1150 @entity887 @entity1031 @entity750 @entity1211 @entity65
BACKGROUND: @entity882 ( @entity882 ) is a severe side effect of the prophylaxis of @entity1211 with unfractionated heparin. The aim of the present study is to gain more information on the incidence of @entity882 during prophylaxis of @entity1211 with low-molecular-weight heparin in elective hip surgery. METHODS: 586 consecutive @entity1 were included into the prospective study, who were admitted to hospital for elective hip replacement. The incidence of @entity882 , clinically manifest @entity1211 and of the heparin-induced IgG antibodies were analysed during prophylaxis with low molecular-weight heparin. @entity1 received once daily subcutaneously low molecular-weight heparin for a mean of 28 days postoperatively. Platelet counts and clinical examinations for the presence of @entity1211 were done at days 0, 2, 7 (+/- 1) and 12 (+/- 2). Heparin-induced IgG antibodies were determined before and after a 12 (+/- 2) days prophylaxis with low molecular-weight heparin in 265 of 586 @entity1 randomly. @entity1 were reexamined for @entity1031 complications after 3 and 6 months. The clinical suspicion of @entity1031 complication was documented objectively. RESULTS: None of the @entity1 developed a decrease of platelets of < 50% of the initial value. Ten of 265 @entity1 had elevated IgG antibodies against heparin/platelet factor 4 before prophylaxis (3.8%). After the 12 (+/- 2) days prophylaxis 13 of 265 @entity1 had elevated IgG antibodies (4.9%). C14 @entity750 assay was positive in 0 of 10 @entity1 before treatment and in 3 of 19 @entity1 at day 12 (+/- 2). Ten @entity1 developed @entity1211 postoperatively (8 x @entity1150 , 2 x @entity1151 , no fatal @entity887 ). Only 1/19 @entity1 with elevated antiheparin IgG titres developed @entity1211 . The C14 @entity750 assay was negative in this @entity1 . Two @entity1 died in the postoperative phase due to underlying @entity65 . CONCLUSIONS: In @entity1 with elective hip replacement prophylaxis of @entity1211 with low molecular-weight heparin was associated with a very low incidence of @entity882 , and hence screening for @entity882 antibodies is not required.
