Low-dose aspirin and the rate of symptomatic venous thromboembolic complications following primary shoulder arthroplasty
| Autor: | Matthew L. Ramsey, Gerald R. Williams, Joseph A. Abboud, Michael J. Gutman, Jacob M. Kirsch, Alex Rondon, Manan S. Patel, Surena Namdari |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Deep vein medicine.medical_treatment 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Humans Medicine Orthopedics and Sports Medicine cardiovascular diseases Retrospective Studies Asthma 030222 orthopedics Aspirin business.industry Incidence Venous Thromboembolism 030229 sport sciences General Medicine medicine.disease Arthroplasty Thrombosis Surgery Pulmonary embolism medicine.anatomical_structure Arthroplasty Replacement Shoulder Orthopedic surgery Chemoprophylaxis Pulmonary Embolism business medicine.drug |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 30:1613-1618 |
| ISSN: | 1058-2746 |
| Popis: | Venous thromboembolism (VTE) events are infrequent but potentially catastrophic complications following orthopedic surgery. There is currently a paucity of evidence regarding the role of chemoprophylaxis with low-dose aspirin (acetylsalicylic acid [ASA]) after shoulder arthroplasty.We conducted a retrospective review of prospectively collected complications occurring within 90 days of 2394 primary shoulder arthroplasties performed over a 3-year period at a single institution. Patients preoperatively underwent risk stratification into medically high risk, moderate risk, or low risk as part of a standardized navigated-care pathway. For chemoprophylaxis, 81 mg of ASA (low dose) was routinely used once daily for 6 weeks unless alternative medications were deemed necessary by the medical team. Baseline demographic information, medical comorbidities, and postoperative VTE prophylaxis, as well as rates of clinically symptomatic VTE, were assessed.Symptomatic VTE occurred after 0.63% of primary shoulder arthroplasties (15 of 2394). There were 9 patients with deep vein thromboses and 6 with pulmonary embolisms. Eighty-one milligrams of ASA was used in 2141 patients (89.4%), resulting in an overall VTE rate of 0.56%. Medically high-risk patients were significantly more likely to have a VTE (P = .018). Patients with a history of deep vein thrombosis, asthma, and cardiac arrhythmia were significantly more likely to have a VTE (P.05). Complications occurred in 4 patients (0.19%) associated with low-dose ASA and 1 patient (0.63%) associated with a novel oral anticoagulant medication.Routine use of low-dose ASA results in a very low risk of VTE and medication-associated complications following primary shoulder arthroplasty. Preoperative medical risk stratification can potentially identify patients at high risk of postoperative VTE. |
| Databáze: | OpenAIRE |
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