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Aspirin prophylaxis is not associated with increased risk of venous thromboembolism in arthroplasty for femoral neck fractures: a non-inferiority study.
- Source :
- European Journal of Orthopaedic Surgery & Traumatology; Apr2024, Vol. 34 Issue 3, p1405-1411, 7p
- Publication Year :
- 2024
-
Abstract
- Purpose: Venous thromboembolism (VTE) is a known complication of hip arthroplasty for femoral neck fractures (FNF) with various prophylactic anticoagulants utilized to decrease risk. The purpose of this study was to assess the efficacy and perioperative outcomes associated with aspirin for VTE prophylaxis following arthroplasty for FNF. Methods: Medical records of 1,220 patients who underwent hip hemiarthroplasty (HHA) or total hip arthroplasty (THA) at an urban academic center from 2011 to 2022 were retrospectively reviewed. Patient characteristics and perioperative outcomes, including length of stay (LOS), VTE, 90-day hospital encounters, and discharge disposition, were collected. Outcomes for patients prescribed aspirin (n = 214) were compared to those prescribed non-aspirin VTE prophylaxis (n = 1006) using propensity score matching. Results: Patients who received aspirin had higher rates of THA (36.0 vs 26.7%; p = 0.008). There were no significant risk-adjusted differences in the incidence of VTE (0.5 vs 0.5%, p = 1.000) and 90-day readmissions (10.4 vs 12.3%, p = 0.646) between patients prescribed aspirin and non-aspirin VTE prophylaxis, respectively. Patients prescribed non-aspirin agents had higher rates of non-home discharge (73.9 vs 58.5%; p < 0.001) and longer LOS (143.5 vs 124.9 h; p = 0.005). Sub-analysis of patients prescribed aspirin and non-aspirin prophylaxis based on comorbidity scores demonstrated no difference in VTE incidence for low (0.0 vs 1.6%, p = 1.000) and high scores (0.0 vs 0.0%, p = 1.000), respectively. Conclusion: Aspirin is not associated with increased incidence of VTE after HHA or THA for FNF. Aspirin prophylaxis should be considered in hip fracture patients to mitigate bleeding risk, particularly those with low to intermediate VTE risk. Level of evidence: Level III, Retrospective study. [ABSTRACT FROM AUTHOR]
- Subjects :
- THROMBOEMBOLISM risk factors
RISK assessment
TOTAL hip replacement
ACADEMIC medical centers
VEINS
ASPIRIN
PATIENT readmissions
TREATMENT effectiveness
RETROSPECTIVE studies
DESCRIPTIVE statistics
DISCHARGE planning
FEMORAL neck fractures
URBAN hospitals
MEDICAL records
ACQUISITION of data
LENGTH of stay in hospitals
Subjects
Details
- Language :
- English
- ISSN :
- 16338065
- Volume :
- 34
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- European Journal of Orthopaedic Surgery & Traumatology
- Publication Type :
- Academic Journal
- Accession number :
- 176338223
- Full Text :
- https://doi.org/10.1007/s00590-023-03816-3