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Despite widespread use of prophylaxis against venous thromboembolism following total hip arthroplasty (THA), the comparative effectiveness of various regimens in preventing the clinically important endpoint of pulmonary embolism (PE) is unclear. Researchers addressed this issue in an analysis of 17,600 THA patients in the Kaiser Permanente system who received aspirin (5%), warfarin (35%), low-molecular-weight heparin (LMWH; 41%), or mechanical prophylaxis only (9%; mostly sequential compression devices or foot pumps); prophylaxis modality was unknown in 7%. Most patients who received chemical prophylaxis also received mechanical prophylaxis.
The overall PE rate was 0.4% at 90 days; only one fatal case was documented. Overall mortality was 0.…