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. 1980 Feb;191(2):207–218. doi: 10.1097/00000658-198002000-00013

Prophylaxis of venous thromboembolism: analysis of cost effectiveness.

E W Salzman, G C Davies
PMCID: PMC1345610  PMID: 6767449

Abstract

The rapidly expanding literature regarding prevention of venous thromboembolism is confusing and contradictory, but, when analysed in the aggregate, the collective experience permits a judgment about the relative efficacy of different prophylactic regimens in specific patient populations, who vary in the risk factors predisposing them to thromboembolism. The dollar cost of the several approaches to prevention and their consequences should also be a matter of concern. Efficacy and dollar cost together determine cost effectiveness, which provides a practical guide to selection of the prophylactic approach appropriate to an individual patient.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abernethy E. A., Hartsuck J. M. Postoperative pulmonary embolism. A prospective study utilizing low dose heparin. Am J Surg. 1974 Dec;128(6):739–742. doi: 10.1016/0002-9610(74)90061-0. [DOI] [PubMed] [Google Scholar]
  2. Allgood R. J., Cook J. H., Weedn R. J., Speed H. K., Whitcomb W. H., Greenfield L. J. Prospective analysis of pulmonary embolism in the postoperative patient. Surgery. 1970 Jul;68(1):116–122. [PubMed] [Google Scholar]
  3. Amador E., Li T. K., Crane C. Ligation of inferior vena cava for thromboembolism. Clinical and autopsy correlations in 119 cases. JAMA. 1968 Nov 18;206(8):1758–1760. [PubMed] [Google Scholar]
  4. Askey J. M. Hemorrhage during long-term anticoagulant drug therapy. 1. Intracranial hemmorrhage. Calif Med. 1966 Jan;104(1):6–10. [PMC free article] [PubMed] [Google Scholar]
  5. BARRITT D. W., JORDAN S. C. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. Lancet. 1960 Jun 18;1(7138):1309–1312. doi: 10.1016/s0140-6736(60)92299-6. [DOI] [PubMed] [Google Scholar]
  6. BAUER G. CLINICAL EXPERIENCES OF A SURGEON IN THE USE OF HEPARIN. Am J Cardiol. 1964 Jul;14:29–35. doi: 10.1016/0002-9149(64)90101-8. [DOI] [PubMed] [Google Scholar]
  7. Barber H. M., Feil E. J., Galasko C. S., Edwards D. H., Sutton R. A., Haynes D. W., Bentley G. A comparative study of dextran-70, warfarin and low-dose heparin for the prophylaxis of thrombo-embolism following total hip replacement. Postgrad Med J. 1977 Mar;53(617):130–133. doi: 10.1136/pgmj.53.617.130. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Becker J., Schampi B. The incidence of postoperative venous thrombosis of the legs. A comparative study on the prophylactic effect of dextran 70 and electrical calf-muscle stimulation. Acta Chir Scand. 1973;139(4):357–367. [PubMed] [Google Scholar]
  9. Bolton J. P., Hoffman V. J. Incidence of early post-operative iliofemoral thrombosis. Br Med J. 1975 Feb 1;1(5952):247–249. doi: 10.1136/bmj.1.5952.247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Bone G. E., McClelland R. N. Management of gastric polyps. Surg Gynecol Obstet. 1976 Jun;142(6):933–938. [PubMed] [Google Scholar]
  11. Brisman R., Parks L. C., Haller J. A., Jr Dextran prophylaxis in surgery. Ann Surg. 1971 Jul;174(1):137–141. doi: 10.1097/00000658-197107010-00022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Browse N. L., Clemenson G., Bateman N. T., Gaunt J. I., Croft D. N. Effect of intravenous dextran 70 and pneumatic leg compression on incidence of postoperative pulmonary embolism. Br Med J. 1976 Nov 27;2(6047):1281–1284. doi: 10.1136/bmj.2.6047.1281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Browse N. L., Clemenson G., Croft D. N. Fibrinogen-detectable thrombosis in the legs and pulmonary embolism. Br Med J. 1974 Mar 30;1(5908):603–604. doi: 10.1136/bmj.1.5908.603. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Browse N. L., Hall J. H. Effect of dipyridamole on the incidence of clinically detectable deep-vein thrombosis. Lancet. 1969 Oct 4;2(7623):718–720. doi: 10.1016/s0140-6736(69)90429-2. [DOI] [PubMed] [Google Scholar]
  15. Carter A. E., Eban R., Perrett R. D. Prevention of postoperative deep venous thrombosis and pulmonary embolism. Br Med J. 1971 Feb 6;1(5744):312–314. doi: 10.1136/bmj.1.5744.312. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Carter A. E., Eban R. Prevention of postoperative deep venous thrombosis in legs by orally administered hydroxychloroquine sulphate. Br Med J. 1974 Jul 13;3(5923):94–95. doi: 10.1136/bmj.3.5923.94. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Carter A. E., Eban R. The prevention of postoperative deep venous thrombosis with dextran 70. Br J Surg. 1973 Sep;60(9):681–683. doi: 10.1002/bjs.1800600905. [DOI] [PubMed] [Google Scholar]
  18. Clark W. B., MacGregor A. B., Prescott R. J., Ruckley C. V. Pneumatic compression of the calf and postoperative deep-vein thrombosis. Lancet. 1974 Jul 6;2(7871):5–7. doi: 10.1016/s0140-6736(74)91344-0. [DOI] [PubMed] [Google Scholar]
  19. Coon W. W. Epidemiology of venous thromboembolism. Ann Surg. 1977 Aug;186(2):149–164. doi: 10.1097/00000658-197708000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Corrigan T. P., Kakkar V. V., Fossard D. P. Proceedings: Low dose subcutaneous heparin--optimal dose regimen. Br J Surg. 1974 Apr;61(4):320–320. [PubMed] [Google Scholar]
  21. Coventry M. B., Nolan D. R., Beckenbaugh R. D. "Delayed" prophylactic anticoagulation: a study of results and complications in 2,012 total hip arthroplasties. J Bone Joint Surg Am. 1973 Oct;55(7):1487–1492. [PubMed] [Google Scholar]
  22. Covey T. H., Sherman L., Baue A. E. Low-dose heparin in postoperative patients: a prospective, coded study. Arch Surg. 1975 Aug;110(8):1021–1026. doi: 10.1001/archsurg.1975.01360140165032. [DOI] [PubMed] [Google Scholar]
  23. D'Ambrosia R. D., Lipscomb P. R., McClain E. J., Wissinger H. A., McDowell J. H., 3rd Prophylactic anticoagulation in total hip replacement. Surg Gynecol Obstet. 1975 Apr;140(4):523–527. [PubMed] [Google Scholar]
  24. Darke S. G. Ilo-femoral venous thrombosis after operations on the hip. A prospective controlled trial using dextran 70. J Bone Joint Surg Br. 1972 Nov;54(4):615–620. [PubMed] [Google Scholar]
  25. Dechavanne M., Ville D., Viala J. J., Kher A., Faivre J., Pousset M. B., Dejour H. Controlled trial of platelet anti-aggregating agents and subcutaneous heparin in prevention of postoperative deep vein thrombosis in high risk patients. Haemostasis. 1975;4(2):94–100. doi: 10.1159/000214092. [DOI] [PubMed] [Google Scholar]
  26. Doig R. L., Browse N. L. Rapid propagation of thrombus in deep vein thrombosis. Br Med J. 1971 Oct 23;4(5781):210–211. doi: 10.1136/bmj.4.5781.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Doouss T. W. The clinical significance of venous thrombosis of the calf. Br J Surg. 1976 May;63(5):377–378. doi: 10.1002/bjs.1800630510. [DOI] [PubMed] [Google Scholar]
  28. Evarts C. M., Alfidi R. J. Thromboembolism after total hip reconstruction. Failure of low doses of heparin in prevention. JAMA. 1973 Jul 30;225(5):515–516. [PubMed] [Google Scholar]
  29. Evarts C. M., Feil E. J. Prevention of thromboembolic disease after elective surgery of the hip. J Bone Joint Surg Am. 1971 Oct;53(7):1271–1280. [PubMed] [Google Scholar]
  30. Flanc C., Kakkar V. V., Clarke M. B. Postoperative deep-vein thrombosis. Effect of intensive prophylaxis. Lancet. 1969 Mar 8;1(7593):477–478. doi: 10.1016/s0140-6736(69)91585-2. [DOI] [PubMed] [Google Scholar]
  31. Flanc C., Kakkar V. V., Clarke M. B. The detection of venous thrombosis of the legs using 125-I-labelled fibrinogen. Br J Surg. 1968 Oct;55(10):742–747. doi: 10.1002/bjs.1800551007. [DOI] [PubMed] [Google Scholar]
  32. Fox M., Saunders N. R. Significance of loin pain in women. A study of 100 consecutive cases referred to a urological clinic. Lancet. 1978 Jan 21;1(8056):115–116. doi: 10.1016/s0140-6736(78)90416-6. [DOI] [PubMed] [Google Scholar]
  33. Gallus A. S., Hirsh J., Gent M. Relevance of preoperative and postoperative blood tests to postoperative leg-vein thrombosis. Lancet. 1973 Oct 13;2(7833):805–809. doi: 10.1016/s0140-6736(73)90855-6. [DOI] [PubMed] [Google Scholar]
  34. Gallus A. S., Hirsh J., O'Brien S. E., McBride J. A., Tuttle R. J., Gent M. Prevention of venous thrombosis with small, subcutaneous doses of heparin. JAMA. 1976 May 3;235(18):1980–1982. [PubMed] [Google Scholar]
  35. Gallus A. S., Hirsh J. Treatment of venous thromboembolic disease. Semin Thromb Hemost. 1976 Apr;2(4):291–331. [PubMed] [Google Scholar]
  36. Gallus A. S., Hirsh J., Tutle R. J., Trebilcock R., O'Brien S. E., Carroll J. J., Minden J. H., Hudecki S. M. Small subcutaneous doses of heparin in prevention of venous thrombosis. N Engl J Med. 1973 Mar 15;288(11):545–551. doi: 10.1056/NEJM197303152881103. [DOI] [PubMed] [Google Scholar]
  37. Gordonaasmith I. C., Grundy D. J., Lequesne L. P., Newcombe J. F., Bramble F. J. Controlled trial of two regimens of subcutaneous heparin in prevention of postoperative deep-vein thrombosis. Lancet. 1972 May 27;1(7761):1133–1135. [PubMed] [Google Scholar]
  38. Gruber U. F., Duckert F., Fridrich R., Torhorst J., Rem J. Prevention of postoperative thromboembolism by dextran 40, low doses of heparin, or xantinol nicotinate. Lancet. 1977 Jan 29;1(8005):207–210. doi: 10.1016/s0140-6736(77)91011-x. [DOI] [PubMed] [Google Scholar]
  39. Hampson W. G., Harris F. C., Lucas H. K., Roberts P. H., McCall I. W., Jackson P. C., Powell N. L., Staddon G. E. Failure of low-dose heparin to prevent deep-vein thrombosis after hip-replacement arthroplasty. Lancet. 1974 Oct 5;2(7884):795–797. doi: 10.1016/s0140-6736(74)91068-x. [DOI] [PubMed] [Google Scholar]
  40. Handley A. J., Emerson P. A., Fleming P. R. Heparin in the prevention of deep vein thrombosis after myocardial infarction. Br Med J. 1972 May 20;2(5811):436–438. doi: 10.1136/bmj.2.5811.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Handley A. J. Low-dose heparin after myocardial infarction. Lancet. 1972 Sep 23;2(7778):623–624. doi: 10.1016/s0140-6736(72)93016-4. [DOI] [PubMed] [Google Scholar]
  42. Harris W. H., Athanasoulis C., Waltman A. C., Salzman E. W. Cuff-impedance phlebography and 125I fibrinogen scanning versus roentgenographic phlebography for diagnosis of thrombophlebitis following hip surgery. A preliminary report. J Bone Joint Surg Am. 1976 Oct;58(7):939–944. [PubMed] [Google Scholar]
  43. Harris W. H., Salzman E. W., Athanasoulis C. A., Waltman A. C., DeSanctis R. W. Aspirin prophylaxis of venous thromboembolism after total hip replacement. N Engl J Med. 1977 Dec 8;297(23):1246–1249. doi: 10.1056/NEJM197712082972302. [DOI] [PubMed] [Google Scholar]
  44. Harris W. H., Salzman E. W., Athanasoulis C., Waltman A. C., Baum S., DeSanctis R. W. Comparison of warfarin, low-molecular-weight dextran, aspirin, and subcutaneous heparin in prevention of venous thromboembolism following total hip replacement. J Bone Joint Surg Am. 1974 Dec;56(8):1552–1562. [PubMed] [Google Scholar]
  45. Harris W. H., Salzman E. W., DeSanctis R. W., Coutts R. D. Prevention of venous thromboembolism following total hip replacement. Warfarin vs dextran 40. JAMA. 1972 Jun 5;220(10):1319–1322. [PubMed] [Google Scholar]
  46. Harris W. H., Salzman E. W., Desanctis R. W. The prevention of thromboembolic disease by prophylactic anticoagulation. A controlled study in elective hip surgery. J Bone Joint Surg Am. 1967 Jan;49(1):81–89. [PubMed] [Google Scholar]
  47. Hartshorn J. W., Teale S. N., Faiz M. Dextran 75 and postoperative phlebitis. Evaluation of dextran 75 in the prophylaxis of postoperative thrombophlebitis, pulmonary embolism, and myocardial infarction. Arch Surg. 1969 Jun;98(6):694–697. doi: 10.1001/archsurg.1969.01340120042003. [DOI] [PubMed] [Google Scholar]
  48. Hartsuck J. M., Greenfield L. J. Postoperative thromboembolism. A clinical study with 125I-fibrinogen and pulmonary scanning. Arch Surg. 1973 Nov;107(5):733–739. doi: 10.1001/archsurg.1973.01350230085017. [DOI] [PubMed] [Google Scholar]
  49. Heparin versus dextran in the prevention of deep-vein thrombosis. A multi-unit coctrolled trial. Lancet. 1974 Jul 20;2(7873):118–120. [PubMed] [Google Scholar]
  50. Hills N. H., Pflug J. J., Jeyasingh K., Boardman L., Calnan J. S. Prevention of deep vein thrombosis by intermittent pneumatic compression of calf. Br Med J. 1972 Jan 15;1(5793):131–135. doi: 10.1136/bmj.1.5793.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Hirsh J., Gallus A. S. 125-I-labeled fibrinogen scanning. Use in the diagnosis of venous thrombosis. JAMA. 1975 Sep 1;233(9):970–973. doi: 10.1001/jama.233.9.970. [DOI] [PubMed] [Google Scholar]
  52. Hume M., Kuriakose T. X., Zuch L., Turner R. H. 125I fibrinogen and the prevention of venous thrombosis. Arch Surg. 1973 Nov;107(5):803–806. doi: 10.1001/archsurg.1973.01350230155028. [DOI] [PubMed] [Google Scholar]
  53. Hume M., Turner R. H., Kuriakose T. X., Surprenant J. Venous thrombosis after total hip replacement. Combined monitoring as a guide for prophylaxis and treatment. J Bone Joint Surg Am. 1976 Oct;58(7):933–939. [PubMed] [Google Scholar]
  54. Huttunen H. J., Mattila M. A., Hakalehto J., Kettunen K., Rehnberg V., Babinski M. Single infusion of dextran 70 in the prophylaxis of postoperative deep venous thrombosis. Ann Chir Gynaecol Fenn. 1971;60(3):119–122. [PubMed] [Google Scholar]
  55. Ivins J. C., Benson W. F., Bickel W. H., Nelson J. W. Arthroplasty of the hip for idiopathic degenerative joint disease. Surg Gynecol Obstet. 1967 Dec;125(6):1281–1284. [PubMed] [Google Scholar]
  56. Jansen H. Dextran as a prophylaxis against thromboembolism in general surgery. Acta Chir Scand Suppl. 1968;387:86–87. [PubMed] [Google Scholar]
  57. Jansen H. Postoperative thromboembolism and its prevention with 500 ml dextran given during operation with a special study of the venous flow pattern in the lower extremities. Acta Chir Scand Suppl. 1972;427:1–73. [PubMed] [Google Scholar]
  58. Jennings J. J., Harris W. H., Sarmiento A. A clinical evaluation of aspirin prophylaxis of thromboembolic disease after total hip arthroplasty. J Bone Joint Surg Am. 1976 Oct;58(7):926–928. [PubMed] [Google Scholar]
  59. Joffe S. N. The incidence of postoperative deep vein thrombosis. Thromb Res. 1975 Jul;7(1):141–148. doi: 10.1016/0049-3848(75)90131-0. [DOI] [PubMed] [Google Scholar]
  60. Joffe S. Drug prevention of postoperative deep vein thrombosis. A compararative study of calcium heparinate and sodium pentosan polysulfate. Arch Surg. 1976 Jan;111(1):37–40. doi: 10.1001/archsurg.1976.01360190039006. [DOI] [PubMed] [Google Scholar]
  61. Johnson R., Green J. R., Charnley J. Pulmonary embolism and its prophylaxis following the Charnley total hip replacement. Clin Orthop Relat Res. 1977;(127):123–132. [PubMed] [Google Scholar]
  62. KOEKENBERG L. J. Experimental use of macrodex as a prophylaxis against post-operative thrombo-embolism. Bull Soc Int Chir. 1962 Sep-Oct;21:501–512. [PubMed] [Google Scholar]
  63. KRAUSE R. J., CRANLEY J. J., HALLABA M. A., STRASSER E. S., HAFNER C. D. Caval ligation in thromboembolic disease. Arch Surg. 1963 Jul;87:184–192. doi: 10.1001/archsurg.1963.01310130186023. [DOI] [PubMed] [Google Scholar]
  64. Kakkar V. V., Corrigan T., Spindler J., Fossard D. P., Flute P. T., Crellin R. Q., Wessler S., Yin E. T. Efficacy of low doses of heparin in prevention of deep-vein thrombosis after major surgery. A double-blind, randomised trial. Lancet. 1972 Jul 15;2(7768):101–106. doi: 10.1016/s0140-6736(72)91595-4. [DOI] [PubMed] [Google Scholar]
  65. Kakkar V. V., Howe C. T., Flanc C., Clarke M. B. Natural history of postoperative deep-vein thrombosis. Lancet. 1969 Aug 2;2(7614):230–232. doi: 10.1016/s0140-6736(69)90002-6. [DOI] [PubMed] [Google Scholar]
  66. Kakkar V. V., Howe C. T., Nicolaides A. N., Renney J. T., Clarke M. B. Deep vein thrombosis of the leg. Is there a "high risk" group? Am J Surg. 1970 Oct;120(4):527–530. doi: 10.1016/s0002-9610(70)80023-x. [DOI] [PubMed] [Google Scholar]
  67. Kakkar V. The diagnosis of deep vein thrombosis using the 125 I fibrinogen test. Arch Surg. 1972 Feb;104(2):152–159. doi: 10.1001/archsurg.1972.04180020032006. [DOI] [PubMed] [Google Scholar]
  68. Kernohan R. J., Todd C. Heparin therapy in thromboembolic disease. Lancet. 1966 Mar 19;1(7438):621–623. doi: 10.1016/s0140-6736(66)90822-1. [DOI] [PubMed] [Google Scholar]
  69. Kline A., Hughes L. E., Campbell H., Williams A., Zlosnick J., Leach K. G. Dextran 70 in prophylaxis of thromboembolic disease after surgery: a clinically oriented randomized double-blind trial. Br Med J. 1975 Apr 19;2(5963):109–112. doi: 10.1136/bmj.2.5963.109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Knight M. T., Dawson R. Effect of intermittent compression of the arms on deep venous thrombosis in the legs. Lancet. 1976 Dec 11;2(7998):1265–1268. doi: 10.1016/s0140-6736(76)92029-8. [DOI] [PubMed] [Google Scholar]
  71. Lahnborg G., Bergström K., Friman L., Lagergren H. Effect of low-dose heparin on incidence of postoperative pulmonary embolism detected by photoscanning. Lancet. 1974 Mar 2;1(7853):329–331. doi: 10.1016/s0140-6736(74)93076-1. [DOI] [PubMed] [Google Scholar]
  72. Loew D., Wellmer H. K., Baer U., Merguet H., Rumpf P., Petersen H., Bromig G., Persch W. F., Marx F. J., von Bary S. M. Postoperative Thrombembolie-Prophylaxe mit Acetylsalicylsäure. Dtsch Med Wochenschr. 1974 Mar 22;99(12):565–572. doi: 10.1055/s-0028-1107803. [DOI] [PubMed] [Google Scholar]
  73. London D., Crosfill M. L. The effect of Dextran '70'* on post-operative deep venous thrombosis. Br J Clin Pract. 1969 Apr;23(4):158–160. [PubMed] [Google Scholar]
  74. Mannucci P. M., Citterio L. E., Panajotopoulos N. Low-dose heparin and deep-vein thrombosis after total hip replacement. Thromb Haemost. 1976 Aug 31;36(1):157–164. [PubMed] [Google Scholar]
  75. McNeil B. J. A diagnostic strategy using ventilation-perfusion studies in patients suspect for pulmonary embolism. J Nucl Med. 1976 Jul;17(7):613–616. [PubMed] [Google Scholar]
  76. Mobin-Uddin K., Utley J. R., Bryant L. R. The inferior vena cava umbrella filter. Prog Cardiovasc Dis. 1975 Mar-Apr;17(5):391–399. doi: 10.1016/s0033-0620(75)80014-4. [DOI] [PubMed] [Google Scholar]
  77. Negus D., Pinto D. J., Le Quesne L. P., Brown N., Chapman M. 125-I-labelled fibrinogen in the diagnosis of deep-vein thrombosis and its correlation with phlebography. Br J Surg. 1968 Nov;55(11):835–839. [PubMed] [Google Scholar]
  78. Nichols A. B., Cochavi S., Hales C. A., Strauss H. W., McKusick K. A., Waltman A. C., Beller G. A. Scintigraphic detection of pulmonary emboli by serial positron imaging of inhaled 15O-labeled carbon dioxide. N Engl J Med. 1978 Aug 10;299(6):279–284. doi: 10.1056/NEJM197808102990604. [DOI] [PubMed] [Google Scholar]
  79. Nicolaides A. N., Dupont P. A., Desai S., Lewis J. D., Douglas J. N., Dodsworth H., Fourides G., Luck R. J., Jamieson C. W. Small doses of subcutaneous sodium heparin in preventing deep venous thrombosis after major surgery. Lancet. 1972 Oct 28;2(7783):890–893. doi: 10.1016/s0140-6736(72)92531-7. [DOI] [PubMed] [Google Scholar]
  80. Nicolaides A., Dupont P., Parsons D., Appleberg M., Horan F. T., Esah K. M., Walker C. J. Proceedings: Small dose subcutaneous sodium heparin in preventing deep venous thrombosis after elective hip surgery. Br J Surg. 1974 Apr;61(4):320–320. [PubMed] [Google Scholar]
  81. O'Sullivan E. F., Hirsh J., McCarthy R. A., de Gruchy G. C. Heparin in the treatment of venous thrombo-embolic disease: administration, control and results. Med J Aust. 1968 Jul 27;2(4):153–159. doi: 10.5694/j.1326-5377.1968.tb29378.x. [DOI] [PubMed] [Google Scholar]
  82. Pachter H. L., Riles T. S. Low dose heparin: bleeding and wound complications in the surgical patient. A prospective randomized study. Ann Surg. 1977 Dec;186(6):669–674. doi: 10.1097/00000658-197712000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  83. Pinto D. J. Controlled trial of an anticoagulant (warfarin sodium) in the prevention of venous thrombosis following hip surgery. Br J Surg. 1970 May;57(5):349–352. doi: 10.1002/bjs.1800570508. [DOI] [PubMed] [Google Scholar]
  84. Ring J., Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet. 1977 Feb 26;1(8009):466–469. doi: 10.1016/s0140-6736(77)91953-5. [DOI] [PubMed] [Google Scholar]
  85. Ritter M. A., HamiltonCW A comparative analysis of warfarin and low-dose heparin as thromboembolism prophylaxis in total hip replacement patinets. Ann Surg. 1975 Jun;181(6):896–901. doi: 10.1097/00000658-197506000-00025. [DOI] [PMC free article] [PubMed] [Google Scholar]
  86. Roberts V. C., Cotton L. T. Failure of low-dose heparin to improve efficacy of peroperative intermittent calf compression in preventing postoperative deep vein thrombosis. Br Med J. 1975 Aug 23;3(5981):458–460. doi: 10.1136/bmj.3.5981.458. [DOI] [PMC free article] [PubMed] [Google Scholar]
  87. Roberts V. C., Cotton L. T. Prevention of postoperative deep vein thrombosis in patients with malignant disease. Br Med J. 1974 Mar 2;1(5904):358–360. doi: 10.1136/bmj.1.5904.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
  88. Robin E. D. Overdiagnosis and overtreatment of pulmonary embolism: the emperor may have no clothes. Ann Intern Med. 1977 Dec;87(6):775–781. doi: 10.7326/0003-4819-87-6-775. [DOI] [PubMed] [Google Scholar]
  89. Rosenberg I. L., Evans M., Pollock A. V. Prophylaxis of postoperative leg vine thrombosis by low dose subcutaneous heparin or peroperative calf muscle stimulation: a controlled clinical trial. Br Med J. 1975 Mar 22;1(5959):649–651. doi: 10.1136/bmj.1.5959.649. [DOI] [PMC free article] [PubMed] [Google Scholar]
  90. Rothermel J. E., Wessinger J. B., Stinchfield F. E. Dextran 40 and thromboembolism in total hip replacement surgery. Arch Surg. 1973 Feb;106(2):135–137. doi: 10.1001/archsurg.1973.01350140003003. [DOI] [PubMed] [Google Scholar]
  91. Sabri S., Roberts V. C., Cotton L. T. Prevention of early postoperative deep vein thrombosis by intermittent compression of the leg during surgery. Br Med J. 1971 Nov 13;4(5784):394–396. doi: 10.1136/bmj.4.5784.394. [DOI] [PMC free article] [PubMed] [Google Scholar]
  92. Sagar S., Massey J., Sanderson J. M. Low-dose heparin prophylaxis against fatal pulmonary embolism. Br Med J. 1975 Nov 1;4(5991):257–259. doi: 10.1136/bmj.4.5991.257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  93. Sagar S., Nairn D., Stamatakis J. D., Maffei F. H., Higgins A. F., Thomas D. P., Kakkar V. V. Efficacy of low-dose heparin in prevention of extensive deep-vein thrombosis in patients undergoing total-hip replacement. Lancet. 1976 May 29;1(7970):1151–1154. doi: 10.1016/s0140-6736(76)91541-5. [DOI] [PubMed] [Google Scholar]
  94. Salzman E. W., Deykin D., Shapiro R. M., Rosenberg R. Management of heparin therapy: Controlled prospective trial. N Engl J Med. 1975 May 15;292(20):1046–1050. doi: 10.1056/NEJM197505152922002. [DOI] [PubMed] [Google Scholar]
  95. Salzman E. W., Harris W. H., DeSanctis R. W. Reduction in venous thromboembolism by agents affecting platelet function. N Engl J Med. 1971 Jun 10;284(23):1287–1292. doi: 10.1056/NEJM197106102842303. [DOI] [PubMed] [Google Scholar]
  96. Salzman E. W., Harris W. H. Prevention of venous thromboembolism in orthopaedic patients. J Bone Joint Surg Am. 1976 Oct;58(7):903–913. [PubMed] [Google Scholar]
  97. Sawyer R. B. Clinical experiences with dextran treatment. Acta Chir Scand Suppl. 1968;387:58–60. [PubMed] [Google Scholar]
  98. Stadil F. Macrodex prophylaxis in postoperative thrombosis. A prelininary communication. Acta Chir Scand Suppl. 1968;387:88–90. [PubMed] [Google Scholar]
  99. Stadil F. Prevention of venous thrombosis. Lancet. 1970 Jul 4;2(7662):50–50. doi: 10.1016/s0140-6736(70)92519-5. [DOI] [PubMed] [Google Scholar]
  100. Stamatakis J. D., Kakkar V. V., Sagar S., Lawrence D., Nairn D., Bentley P. G. Femoral vein thrombosis and total hip replacement. Br Med J. 1977 Jul 23;2(6081):223–225. doi: 10.1136/bmj.2.6081.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  101. Stephenson C. B., Wallace J. C., Vaughan J. V. Dextran 70 in the prevention of post-operative deep-vein thrombosis with observations on pulmonary embolism: report on a pilot study. N Z Med J. 1973 May;77(492):302–305. [PubMed] [Google Scholar]
  102. Strand L., Bank-Mikkelsen O. K., Lindewald H. Small heparin doses as prophylaxis against deep-vein thrombosis in major surgery. Acta Chir Scand. 1975;141(7):624–627. [PubMed] [Google Scholar]
  103. Tsapogas M. J., Miller R., Peabody R. A., Eckert C. L. Detection of postoperative venous thrombosis and effectiveness of prophylactic measures studied with the fibrinogen 125-I technique. Arch Surg. 1970 Aug;101(2):149–154. doi: 10.1001/archsurg.1970.01340260053009. [DOI] [PubMed] [Google Scholar]
  104. Vasilescu C. Proceedings: A multi-unit trial of dextran and heparin in the prophylaxis of deep vein thrombosis. Br J Surg. 1974 Apr;61(4):320–320. [PubMed] [Google Scholar]
  105. Warlow C., Terry G., Kenmure A. C., Beattie A. G., Ogston D., Douglas A. S. A double-blind trial of low doses of subcutaneous heparin in the prevention of deep-vein thrombosis after myocardial infarction. Lancet. 1973 Oct 27;2(7835):934–936. doi: 10.1016/s0140-6736(73)92597-x. [DOI] [PubMed] [Google Scholar]
  106. Weinstein M. C., Stason W. B. Foundations of cost-effectiveness analysis for health and medical practices. N Engl J Med. 1977 Mar 31;296(13):716–721. doi: 10.1056/NEJM197703312961304. [DOI] [PubMed] [Google Scholar]
  107. Williams H. T. Prevention of postoperative deep-vein thrombosis with perioperative subcutaneous heparin. Lancet. 1971 Oct 30;2(7731):950–952. doi: 10.1016/s0140-6736(71)90270-4. [DOI] [PubMed] [Google Scholar]
  108. Williams J. W., Eikman E. A., Greenberg S. H., Hewitt J. C., Lopez-Cuenca E., Jones G. P., Madden J. A. Failure of low dose heparin to prevent pulmonary embolism after hip surgery or above the knee amputation. Ann Surg. 1978 Oct;188(4):468–474. doi: 10.1097/00000658-197810000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  109. Wilson P. D., Jr, Amstutz H. C., Czerniecki A., Salvati E. A., Mendes D. G. Total hip replacement with fixation by acrylic cement. A preliminary study of 100 consecutive McKee-Farrar prosthetic replacements. J Bone Joint Surg Am. 1972 Mar;54(2):207–236. [PubMed] [Google Scholar]
  110. Wu T. K., Tsapogas M. J., Jordan F. R. Prophylaxis of deep venous thrombosis by hydroxychloroquine sulfate and heparin. Surg Gynecol Obstet. 1977 Nov;145(5):714–718. [PubMed] [Google Scholar]
  111. van Vroonhoven T. J., van Zijl J., Muller H. Low-dose subcutaneous heparin versus oral anticoagulants in the prevention of postoperative deep-venous thrombosis. A controlled clinical trial. Lancet. 1974 Mar 9;1(7854):375–378. doi: 10.1016/s0140-6736(74)93147-x. [DOI] [PubMed] [Google Scholar]

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