[Indications for out-of-hospital thromboprophylaxis].

In the last decade the performance of an adequate perioperative prophylaxis for venous thromboembolism (VTE) has become an established in-hospital measure. Although new antithrombotic drugs (oral thrombin inhibitors, fondaparinux) could reduce the incidence of perioperative VTE the absolute number remains high. In contrast to the widely accepted in-hospital perioperative prophylaxis, it is still unclear whether prophylaxis has to be prolonged after the hospital stay ("out-of-hospital prophylaxis").

Reduction of venous thromboembolism following prolonged prophylaxis with the low molecular weight heparin Certoparin after endoprothetic joint replacement or osteosynthesis of the lower limb in elderly patients.

The peri- and postsurgical thromboembolic prophylaxis with low molecular weight heparins is a well established therapy regimen, but the optimum duration of prophylaxis after surgery still remains uncertain. A few studies have pointed to the fact that the thromboembolic risk of high-risk patients persists longer than the in-hospital period correlating with respective hypercoagulatory conditions. The aim of the present study was to test if a prolongation of thromboprophylaxis with the low molecular weight heparin Certoparin further reduces the rate of thromboembolism in high-risk patients after orthopedic surgery.