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