Oct 1, 1977

Surgery, venous thrombosis and anti-Xa

The British Journal of Surgery
J D StamatakisV V Kakkar


Deep venous thrombosis is a common and unpredictable complication of surgery. In this study it is proposed that patients who develop this complication may be predicted by a low preoperative level of a naturally occurring inhibitor of coagulation, anti-Xa. Two groups of patients were investigated. Women taking the oral contraceptive pill had lower preoperative anti-Xa levels than their non-pill controls (P less than 0.01) and in addition had a significantly higher incidence of deep venous thrombosis (DVT) following emergency surgery (P less than 0.05). In 90 patients undergoing total hip replacement, the mean preoperative anti-Xa level of those patients who developed DVT was significantly lower than those who did not (P less than 0.001). Ninety-four per cent of patients with a preoperative anti-Xa level of less than 80 per cent developed DVT. The effect of low dose heparin on anti-Xa was studied. The results suggest a mechanism for the cause of postoperative thrombosis which also permits selection of individual patients who will develop this complication.

Mentioned in this Paper

Contraceptives, Oral
Deep Vein Thrombosis
Venous Thrombosis
Heparin, porcine

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