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Dextran in the Prophylaxis of Deep-Vein Thrombosis

David Bergqvist
JAMA. 1987;258(3):324-325. doi:10.1001/jama.1987.03400030040019.
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To the Editor.—  The article by Oster et al1 entitled "A Cost-effectiveness Analysis of Prophylaxis Against Deep-Vein Thrombosis in Major Orthopedic Surgery" is an important document that clearly shows that thromboprophylaxis saves both lives and health care money. It is of great importance for all of us to spread this knowledge.The authors did not consider dextran because of "a significant rate of complications" and because it had not been found to be cost-effective. I would like to make three comments because I believe that this view is in part based on a misconception:

  1. In most of the studies on the prophylaxis of thrombosis using dextran, dextran 70 has been used. Although the available evidence suggests that dextran 40 and dextran 70 are equally effective in preventing thromboembolism, the overwhelming majority of studies used dextran 70. I agree with the authors that there has been no placebo-controlled study


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