Readmission after hysterectomy and prophylactic low molecular weight heparin: retrospective case-control study.

Abstract:

OBJECTIVE:To determine whether use of tinzaparin, a low molecular weight heparin introduced for prophylactic management of deep vein thrombosis, increases the risk of serious postoperative bleeding leading to a higher than expected 28 day readmission rate after discharge for hysterectomy. DESIGN:Retrospective case-control study using computerised hospital inpatient data and review of case notes. SETTING:District general hospital. SUBJECTS:2108 patients undergoing hysterectomy between August 1997 and March 2003 MAIN OUTCOME MEASURES:Readmission and reoperation associated with bleeding. RESULTS:54 cases of serious postoperative bleeding were identified, 46 of which were readmissions. These 54 cases were compared with 179 controls. Regression analysis indicated a positive relation between prophylaxis with tinzaparin and serious postoperative bleeding. There was a significant twofold increase in odds (odds ratio 2.02, 95% confidence interval 1.02 to 4.05) after adjustment for type of operation, age, and type of pain relief. CONCLUSIONS:In the prophylactic treatment of thromboembolic disease after hysterectomy, compared with calci-heparin, tinzaperin is associated with a twofold increase in risk of serious postoperative bleeding.

journal_name

BMJ

authors

Cook G,Depares J,Singh M,McElduff P

doi

10.1136/bmj.38783.624444.55

keywords:

subject

Has Abstract

pub_date

2006-04-08 00:00:00

pages

819-20

issue

7545

eissn

0959-8138

issn

1756-1833

pii

bmj.38783.624444.55

journal_volume

332

pub_type

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