Aspirin monotherapy is a suitable standard thromboprophylactic agent following total hip arthroplasty
- 18 February 2021
- journal article
- research article
- Published by SAGE Publications in HIP International
- Vol. 32 (3), 286-290
- https://doi.org/10.1177/1120700021990544
Abstract
Aspirin is increasingly recognised as an efficacious thromboprophylactic agent with a superior safety profile compared to alternatives. Following our institution’s previously published experience we implemented a risk-stratified protocol utilising aspirin as standard. We now present retrospective review of standard use of aspirin on fatal pulmonary embolism, all-cause mortality, and venous thromboembolism (VTE) following total hip arthroplasty (THA). A consecutive series of elective THAs was identified. Prospectively maintained databases were analysed to yield demographic data and identify deaths or readmission data. Patients who died within 90 postoperative days underwent review of the complete medical record. 4204 THAs were included in the study cohort. VTE prophylaxis prescription was available in 3805. 2560 received aspirin (67.3%), 1049 enoxaparin (27.6%) and 193 warfarin (5.1%); there were no differences in 90-day all-cause mortality (p = 0.780) or VTE (p = 1) between groups Our large series continues to demonstrate that aspirin for thromboprophylaxis following THA is effective in risk-stratified patients. Furthermore, we demonstrate that introduction of a departmental protocol establishing aspirin as standard practice was not associated with increased mortality or incidence of thromboembolism. Taken in conjunction with our previous cohort our series encompasses 11,420 consecutive THAs. There has been a single death following fatal PE in the aspirin group (0.02%) compared to 5 in the LMWH group (0.2%) and 1 in the warfarin group (0.06%). We join calls for large-scale randomised controlled trials to elucidate the place of aspirin in VTE prevention following hip arthroplasty.Keywords
This publication has 22 references indexed in Scilit:
- The Effectiveness of a Risk Stratification Protocol for Thromboembolism Prophylaxis After Hip and Knee ArthroplastyThe Journal of Arthroplasty, 2016
- Fatal pulmonary embolism following elective total hip arthroplastyThe Bone & Joint Journal, 2016
- Aspirin as Thromboprophylaxis in Hip and Knee Arthroplasty: A Systematic Review and Meta-AnalysisThe Journal of Arthroplasty, 2016
- Aspirin Is as Effective as and Safer Than Warfarin for Patients at Higher Risk of Venous Thromboembolism Undergoing Total Joint ArthroplastyThe Journal of Arthroplasty, 2016
- Aspirin for thromboprophylaxis after primary lower limb arthroplastyThe Bone & Joint Journal, 2016
- Direct Costs of Aspirin versus Warfarin for Venous Thromboembolism Prophylaxis after Total Knee or Hip ArthroplastyThe Journal of Arthroplasty, 2015
- Cost-Effective Prophylaxis Against Venous Thromboembolism After Total Joint Arthroplasty: Warfarin Versus AspirinThe Journal of Arthroplasty, 2015
- Aspirin for Preventing the Recurrence of Venous ThromboembolismNew England Journal of Medicine, 2012
- Prevention of VTE in Orthopedic Surgery Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice GuidelinesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2012
- Prevalence of Primary and Revision Total Hip and Knee Arthroplasty in the United States From 1990 Through 2002The Journal of Bone and Joint Surgery (American), 2005