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Trial registered on ANZCTR
Registration number
ACTRN12614000663651
Ethics application status
Approved
Date submitted
18/06/2014
Date registered
25/06/2014
Date last updated
25/06/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
Treatment of pelvic and acetabular fractures with variable dose heparin for the prevention of pulmonary embolus.
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Scientific title
The incidence of pulmonary embolus in patients with pelvic and acetabular fractures treated with variable dose heparin as prophylaxis to pulmonary embolus
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Secondary ID [1]
284830
0
Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pulmonary embolus
292215
0
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Pelvic and acetabular fractures
292252
0
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Condition category
Condition code
Blood
292551
292551
0
0
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Clotting disorders
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Injuries and Accidents
292593
292593
0
0
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Fractures
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Cardiovascular
292594
292594
0
0
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Variable dose unfractionated heparin, commencing 48 post injury, or post surgery, administered subcutaneously 8 hourly, according to a sliding scale based on APTT:
<24 +1000 units
24-28 +500 units
29-32 No change
33-37 - 500 units
>37 - 1000 units
Heparin ceased 8 hours pre-operatively. Heparin ceased one week post-operatively, once patient warfarinised.
Patients observed for any clinical evidence of pulmonary embolism, then confirmed with investigations (ventilation-perfusion lung scans early in the study and CT angiography or MRI angiography when those investigations became available)
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Intervention code [1]
289622
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Not applicable
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Comparator / control treatment
Published results of the incidence of pulmonary embolus in patients with pelvic and acetabular fractures treated with fixed dose regimens of fractionated or unfractionated heparin - 1983-2005
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Control group
Historical
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Outcomes
Primary outcome [1]
292413
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Clinical evidence of pulmonary embolus, investigated with ventilation-perfusion lung scans early in the study and CT angiography or MRI angiography when thosed investigations became available
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Assessment method [1]
292413
0
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Timepoint [1]
292413
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Within 6 months of injury
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Secondary outcome [1]
308894
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Nil
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Assessment method [1]
308894
0
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Timepoint [1]
308894
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Nil
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Eligibility
Key inclusion criteria
Patients referred for treatments of pelvic and acetabular fractures and treated with variable dose unfractionated heparin as prophylaxis to pulmonary embolus
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients referred for treatment of pelvic and acetabular fractures and commenced on treatment with fixed dose regimens of fractionated or unfractionated heparin as prophylaxis to pulmonary embolus
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
All patients fulfilling inclusion criteria over 20 years.
This was an observational study commenced at onset as standard of care. When clinical observation indicated an inordinately low rate of pulmonary embolus, the prospectively collected data was reviewed retrospectively over a 20 year time period (1987-2007)
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/1987
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Actual
7/08/1987
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Date of last participant enrolment
Anticipated
30/05/2007
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Actual
10/06/2007
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
369
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
2656
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The Royal Adelaide Hospital - Adelaide
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Funding & Sponsors
Funding source category [1]
289437
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Hospital
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Name [1]
289437
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Royal Adelaide Hospital
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Address [1]
289437
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Frome Road
Adelaide
SA 5000
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Country [1]
289437
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Australia
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Primary sponsor type
Individual
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Name
Dr A.P.Pohl
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Address
Discipline of Orthopaedics & Trauma
Level 4, Bice Building
Royal Adelaide Hospital
Frome Street
Adelaide
SA 5000
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Country
Australia
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Secondary sponsor category [1]
288127
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Hospital
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Name [1]
288127
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Royal Adelaide Hospital
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Address [1]
288127
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Frome Road
Adelaide
SA 5000
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Country [1]
288127
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
291196
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Royal Adelaide Hospital Research Ethics Committee
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Ethics committee address [1]
291196
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Medical Administration Level 3, Margaret Graham Building Royal Adelaide Hospital Frome Road Adelaide SA 5000
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Ethics committee country [1]
291196
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Australia
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Date submitted for ethics approval [1]
291196
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23/09/1998
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Approval date [1]
291196
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30/09/1998
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Ethics approval number [1]
291196
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980911
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Summary
Brief summary
This was a prospective study of 369 consecutive patients referred to a single surgeon for treatment of pelvic and acetabular fractures over a 20 year period. All patients were treated with chemoprophylaxis using unfractionated heparin, according to a sliding scale, at an ‘antithrombotic’ dose. Treatment was withheld for 48 hours post-injury and 48 hours post-operatively, due to the risk of bleeding. Patients were fully anticoagulated with warfarin 7 days post-operatively when the risk of secondary bleeding was over. Patients with clinical evidence of pulmonary embolus (PE) were investigated with ventilation-perfusion lung scans early in the study and CT angiography or MRI angiography when those investigations became available. Seven patients developed PE (1.9%). There was 1 fatal PE (0.3%) CONCLUSION: Variable dose unfractionated heparin followed by warfarin offers excellent protection against PE compared to published results of fixed dose regimens using fractionated heparin or unfractionated heparin in patients with pelvic and acetabular fractures.
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Trial website
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Trial related presentations / publications
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Public notes
This was an observational study commenced in 1987 at onset of my treatment of patients with pelvic and acetabular fractures. Data was collected propectively as standard of care. When clinical observation suggested an inordinately low rate of pulmonary embolus, ethics committee approval was sought for a study and data was reviewed retrospectively and data collection continued prospectively.
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Contacts
Principal investigator
Name
49302
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A/Prof Anthony Pohl
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Address
49302
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Discipline of Orthopaedics & Trauma
Level 4, Bice Building
Royal Adelaide Hospital
Frome Road
Adelaide
SA 5000
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Country
49302
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Australia
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Phone
49302
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+61 8 8222-5535/+61 (0)401123778
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Fax
49302
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+61 8 8232-3065
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Email
49302
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[email protected]
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Contact person for public queries
Name
49303
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Anthony Pohl
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Address
49303
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Discipline of Orthopaedics & Trauma
Level 4, Bice Building
Royal Adelaide Hospital
Frome Road
Adelaide
SA 5000
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Country
49303
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Australia
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Phone
49303
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+61 8 82225535/+61 (0)401123778
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Fax
49303
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+61 8 8232-3065
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Email
49303
0
[email protected]
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Contact person for scientific queries
Name
49304
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Anthony Pohl
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Address
49304
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Discipline of Orthopaedics & Trauma
Level 4, Bice Building
Royal Adelaide Hospital
Frome Road
Adelaide
SA 5000
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Country
49304
0
Australia
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Phone
49304
0
+61 8 82225535/+61 (0)401123778
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Fax
49304
0
+61 8 8232-3065
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Email
49304
0
[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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