Related Experiment Video
Updated: Aug 20, 2025
11:17
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
13.8K
A Prospective Randomized Controlled Trial Comparing Enoxaparin & Rivaroxaban for Venous Thromboembolism Prophylaxis
Mitchell P John1, Benjamin D Streufert1, Katheryne Downes2
1Department of Orthopaedic Surgery, University of South Florida, Tampa, FL.
Journal of Orthopaedic Trauma
|November 18, 2022
Summary
Orthopaedic trauma patients showed higher satisfaction with oral rivaroxaban compared to injectable enoxaparin for preventing blood clots. Adherence and effectiveness were similar, with fewer side effects and lower costs for rivaroxaban.
Area of Science:
- Orthopaedic Surgery
- Pharmacology
- Clinical Trials
Background:
- Venous thromboembolism (VTE) chemoprophylaxis is crucial for orthopaedic trauma patients.
- Current standard treatments include injectable anticoagulants like enoxaparin.
- Patient satisfaction and adherence can impact treatment effectiveness.
Purpose of the Study:
- To compare patient satisfaction and medication adherence between oral rivaroxaban and subcutaneous enoxaparin for VTE chemoprophylaxis in orthopaedic trauma patients.
- To evaluate the efficacy and safety of these anticoagulants in this population.
Main Methods:
- A randomized controlled trial was conducted with 120 adult orthopaedic trauma patients.
- Patients received either enoxaparin (40 mg daily) or rivaroxaban (10 mg daily) for three weeks postoperatively.
- Patient satisfaction was assessed using the TSQM-9, and adherence was measured by the MMAS-8.
Main Results:
- Medication adherence was comparable between the enoxaparin and rivaroxaban groups.
- Patient satisfaction was significantly higher with oral rivaroxaban.
- No significant differences in VTE or bleeding events were observed; rivaroxaban had fewer adverse events and lower out-of-pocket costs for uninsured patients.
Conclusions:
- Oral rivaroxaban is a preferred and potentially viable option for VTE chemoprophylaxis in orthopaedic trauma patients due to higher satisfaction and favorable safety/cost profiles.
- Further large-scale studies are warranted to confirm the safety and efficacy of rivaroxaban as an alternative to enoxaparin.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
16
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
16
01:30Venous Thrombosis IV: Nursing Management
19
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
19
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
31
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
31
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.3K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.3K
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
26
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
26
01:30Venous Thrombosis I: Introduction
23
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
23