BMJ 1995;311:572 (26 August)

Letters

Overall survival rate is most important measure

EDITOR,--The audit of hip fracture in East Anglia concludes that anticoagulant prophylaxis against thromboembolism reduces the frequency of fatal pulmonary embolism.1 The haemorrhagic side effects of such treatment may, however, be important in a group of patients known to have a high prevalence of coexisting cardiovascular and gastrointestinal disease.2 The overall mortality rather than the mortality related to pulmonary embolism should therefore be recorded.

When hospital 6, which seemed to confer an idiosyncratic benefit to patients, is excluded the 90 day survival was marginally lower in the hospitals in which pharmaceutical thromboprophylaxis was used routinely than in those in which it was not (table). The mortality from causes other than pulmonary embolism was significantly higher in the hospitals in which prophylaxis was used routinely {chi}2=5.5, P=0.02). 


90 Day survival and mortality from pulmonary embolism
according to use of prophylaxis (figures are numbers
(percentages))
------------------------------------------------------------
                                         Death due to:
------------------------------------------------------------
             No of     . . . [Full text of this article]


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Relevant Article

Differences in mortality after fracture of hip: the East Anglian audit
C J Todd, C J Freeman, C Camilleri-Ferrante, C R Palmer, A Hyder, C E Laxton, M J Parker, B V Payne, and N Rushton
BMJ 1995 310: 904-908. [Abstract] [Full Text]

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