Aspirin Alone Is Not Enough to Prevent Deep Venous Thrombosis After Total Joint Arthroplasty
| Autor: | Ritesh R. Shah, Wayne M. Goldstein, Colin Y.L. Woon, Jeffrey M. Goldstein, Nancy E. Cipparrone, Brian E. Schwartz, Brandon M Pardi |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class medicine.medical_treatment Arthroplasty Replacement Hip Chemoprevention 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Enoxaparin Arthroplasty Replacement Knee Aged Retrospective Studies Venous Thrombosis 030222 orthopedics Aspirin business.industry Anticoagulant Warfarin Anticoagulants Retrospective cohort study Middle Aged medicine.disease Arthroplasty Pulmonary embolism Surgery Venous thrombosis Chemoprophylaxis Drug Therapy Combination Female business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | Orthopedics. 42(1) |
| ISSN: | 1938-2367 |
| Popis: | Thromboembolic events after total joint arthroplasty are potentially devastating complications. This study evaluated the efficacy of 4 different anticoagulants in preventing deep venous thrombosis and pulmonary embolism after total joint arthroplasty. The demographics and anticoagulant use (warfarin, enoxaparin, and aspirin with and without outpatient mechanical pumps) for patients who underwent primary unilateral total joint arthroplasties performed by a single surgeon from January 2013 to October 2014 were retrospectively reviewed. All patients underwent lower extremity ultrasound at the 3-week postoperative visit. A total of 613 primary unilateral total joint arthroplasties met the study inclusion criteria. There were 288 primary total knee arthroplasties and 325 primary total hip arthroplasties. The patients were 62.2% female, having a mean age of 67.6±10.6 years and a mean body mass index of 30.2±5.9 kg/m 2 . There were 119 patients in group 1 (aspirin alone), 40 patients in group 2 (aspirin plus pumps), 246 patients in group 3 (warfarin), and 208 patients in group 4 (enoxaparin). The overall 3-week symptomatic and asymptomatic deep venous thrombosis and symptomatic pulmonary embolism rates in the entire cohort were 5.7% and 0.3%, respectively. The venous thromboembolism rate was significantly affected by the anticoagulant of choice ( P P P =.05). This study indicated that aspirin chemoprophylaxis alone was not as efficacious as warfarin and enoxaparin in preventing asymptomatic and symptomatic venous thromboembolism found during routine postoperative surveillance with lower extremity ultrasound. Aspirin alone may be inadequate and should be augmented with an outpatient mechanical pump as part of multimodal prophylaxis. [ Orthopedics . 2019; 42(1):48–55.] |
| Databáze: | OpenAIRE |
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