PREVENTION OF FATAL POSTOPERATIVE PULMONARY EMBOLISM BY LOW-DOSE HEPARIN

The efficacy of low-dose heparin to prevent fatal postoperative pulmonary embolism was investigated in this multicentered trial. The original data from 28 trial centers were published in 1975 but inadequacies in data from 1 center led to recomputation of these data excluding the 1 questionable centers results. Of 4031 patients remaining after exclusion of these data 2033 were in the control group and 1998 in the heparin-treated groups. 4.2% (n=170) died postoperatively overall: 94 among controls and 76 in the heparin group. Autopsies were performed on 70.2% of controls and 65.7% of heparin patients. 21% (n=15) of controls autopsied died due to actue massive fatal pulmonary embolism whereas none of the heparin-treated subjects died from postoperative pulmonary embolism. (P < .001). Data exclusion did not significantly alter the total incidence of deep-vein thrombosis nor of bleeding complications observed in both groups postoperatively.