• OBJECTIVE
    • To compare the rates of deep venous thrombosis (DVT), rates of pulmonary embolus (PE), and complication profiles of warfarin and low-molecular-weight heparin (LMWH) in patients undergoing operative fixation of hip fractures.
  • DESIGN
    • Retrospective cohort study.
  • SETTING
    • Insurance-based database of more than 22 million patient records.
  • PATIENTS
    • Adult hip fracture patients who were treated operatively and received chemoprophylaxis from 2007 to 2016. A total of 7594 patients met inclusion criteria and were available for final analysis.
  • INTERVENTION
    • Pharmacological anticoagulation with warfarin or LMWH to prevent postoperative venous thromboembolism after hip fracture surgery.
  • MAIN OUTCOME MEASURES
    • Development of DVT or PE within 30 and 90 days of surgery.
  • RESULTS
    • Patients prescribed warfarin had higher rates of DVT and PE compared with those prescribed LMWH. Patients on warfarin were more likely to develop a postoperative hematoma and to be readmitted within 30 and 90 days compared with those on LMWH. Patients in both groups had similar rates of total complications.
  • CONCLUSIONS
    • Patients prescribed warfarin after hip fractures had higher rates of DVT and PE compared with those prescribed LMWH, although both agents had similar complication profiles.
  • LEVEL OF EVIDENCE
    • Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.