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Venous Thromboembolism Prophylaxis in Orthopedic Surgery

Slide: 26 of 30

Summary of Outcomes From the RECORD Trials

This slide summarizes the results for the composite primary efficacy outcome of deep vein thrombosis (DVT), nonfatal pulmonary embolism (PE), or all-cause mortality in patients who have had THR or TKR surgery from the four Regulation of Coagulation in Orthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism (RECORD) trials. Rivaroxaban decreased the risk of the composite primary outcome of DVT, nonfatal PE, or all-cause mortality in patients from all four trials. RECORD 1 and 2 showed superiority of prolonged prophylaxis with rivaroxaban versus enoxaparin (prolonged or standard prophylaxis) with a decreased risk of the primary outcome in patients undergoing THR. RECORD 3 and 4 suggest that rivaroxaban decreased the risk of the primary outcome versus enoxaparin when used for prophylaxis for patients undergoing TKR. There were no significant differences in mortality or the risk for bleeding outcomes in all four trials.

Abbreviations: 95% CI = 95-percent confidence interval; ARR = absolute risk reduction; DVT = deep vein thrombosis; PE = pulmonary embolism; THR = total hip replacement; TKR = total knee replacement