A retrospective observational study to compare the safety of fondaparinux versus enoxaparin among patients who underwent hemiarthroplasty

Background: Major orthopedic surgeries carry a high risk of venous thromboembolism. Enoxaparin has been in use for this indication for a long time. Fondaparinux, a relatively new anticoagulant, has also shown favorable results. Till date, there are limited studies comparing the safety of fondaparinux with enoxaparin in Indian patients undergoing major orthopedic surgery. Aim: The aim of this study was to compare the safety of fondaparinux with enoxaparin in the real-life setting. Materials and Methods: Patients who underwent hemiarthroplasty between January 2016 and December 2017, and who were administered fondaparinux or enoxaparin were retrospectively analyzed using patient case files, discharge database, and blood bank database. The safety was assessed based on the requirement of blood transfusion, need for reexploration, wound complications, any occurrence of bleeding, and death from all causes. Pearson’s chi-square test was used using the Statistical Package for the Social Sciences (SPSS) software (IBM, India), version 16. Results: The safety profile of fondaparinux was comparable with enoxaparin with regard to occurrence of bleeding, transfusion requirements, wound complications, and need for reexploration. A higher proportion of patients on fondaparinux had to be given blood transfusion, though this difference was not statistically significant (P = 0.120). Conclusion: In patients who underwent hemiarthroplasty, safety of fondaparinux was comparable to enoxaparin in actual clinical experience.