Dalteparin vs. enoxaparin as prophylaxis for deep-vein thrombosis after total hip or knee arthroplasty - A retrospective analysis

Objective: To assess the clinical and economic consequences of a formulary switch from enoxaparin to dalteparin as first-line prophylaxis for deep-vei n thrombosis in patients undergoing inpatient rehabilitation after total hi p arthroplasty or total knee arthroplasty. Design: Retrospective cohort study. Results: There were 461 patients eligible for the study. The age-adjusted r isk of a deep-vein thrombosis event confirmed by duplex ultrasonography amo ng patients treated with dalteparin was substantially lower than among pati ents treated with enoxaparin, whereas the age-adjusted risk of a bleeding e vent in the dalteparin group was also lower than that in the enoxaparin gro up. Adjusted per capita costs of deep-vein thrombosis prophylaxis during th e rehabilitation stay were $129 lower among subjects treated with daltepari n. Conclusion: The switch to dalteparin as a first-line therapy for deep-vein thrombosis prophylaxis in the rehabilitation period after total hip arthrop lasty or total knee arthroplasty has led to substantial cost savings for Ke ssler Institute without compromising patient care.