[Ortho] Aspirin Can Be Used as Prophylaxis for Prevention of Venous Thromboembolism After Revision Hip and Knee Arthroplasty

Alexander Chelnokov orthoforum на weborto.net
Вт Ноя 1 02:07:43 YEKT 2016


Аспирин опять лучше варфарина для профилактики тромбоэмболических 
осложнений... Не пора ли пересматривать клинические рекомендации?

J Arthroplasty. 2016 Oct;31(10):2237-40. doi: 
10.1016/j.arth.2016.03.031. Epub 2016 Mar 30.

Aspirin Can Be Used as Prophylaxis for Prevention of Venous 
Thromboembolism After Revision Hip and Knee Arthroplasty.

Deirmengian GK1, Heller S1, Smith EB1, Maltenfort M1, Chen AF1, Parvizi J1.

Author information

1Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.

Abstract

BACKGROUND:

The optimal prophylaxis for prevention of venous thromboembolic events 
(VTEs) after revision total joint arthroplasty (TJA) remains unknown. 
The objective of this study was to evaluate whether aspirin, known to be 
effective for prevention of VTEs after primary arthroplasty, is also 
effective after revision TJA.



METHODS:

We studied 2997 consecutive patients who underwent revision TJA between 
2005 and 2013 and were treated with intermittent pneumatic compression 
devices and either aspirin (534 patients) or warfarin (2463 patients) 
for VTE prophylaxis. Pertinent data including the incidence of 
symptomatic VTEs, bleeding events, infection, and mortality were 
retrieved from our prospectively collected database.



RESULTS:

The incidence of symptomatic VTEs was significantly higher in the 
warfarin group at 1.75% (43 of 2463) compared with 0.56% (3 of 534) in 
the aspirin group (odds ratio: 3.2; 95% CI: 1.03-16.3; P = .03). There 
was a higher rate of bleeding events with administration of warfarin 
(1.5%) compared with aspirin (0.4%; P = .02; odds ratio: 4.1; 95% CI: 
1.2-34.0). The rate of surgical site infection was similar between the 
aspirin group and the warfarin group (1.61% and 1.70%, respectively).



CONCLUSION:

Administration of aspirin as prophylaxis against VTEs after revision 
arthroplasty may be a viable option as it appears to be more effective 
than warfarin in prevention of symptomatic VTEs and is associated with a 
lower rate of complications.



PMID: 27118182 DOI: 10.1016/j.arth.2016.03.031

https://www.ncbi.nlm.nih.gov/pubmed/27118182

Alexander Chelnokov





Подробная информация о списке рассылки Ortho