THE RISK OF VENOUS THROMBOEMBOLISM WITH ASPIRIN COMPARED TO ANTICOAGULANTS AFTER HIP OR KNEE ARTHROPLASTY

Janet N. Chu, MD, MPH*1;Andrew D Auerbach, MD, MPH2;Judith Maselli, MSPH3 and Margaret C. Fang, MD, MPH3, (1)University of California, San Francisco, San Francisco, CA, (2)University of California San Francisco, San Francisco, CA, (3)Division of Hospital Medicine, University of California San Francisco, San Francisco, CA

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 72

Categories: Outcomes Research, Research Abstracts

Keywords: , , ,

Background: Recent guidelines include aspirin as an option to prevent venous thromboembolism (VTE) in selected patients undergoing hip or knee replacement surgery. However, the efficacy of aspirin after arthroplasty has not been well-defined, particularly in more contemporary patient populations.

Objective: To compare rates of post-operative VTE between patients who received aspirin-only versus anticoagulants after hip or knee arthroplasty, using data from a large US-based administrative database.

Methods: We identified 231,780 adults who underwent total knee arthroplasty and 110,621 who underwent total hip arthroplasty in 2009-2012 and who received pharmacologic VTE prophylaxis (aspirin or anticoagulant) within the first 7 days after surgery. We compared the risk of post-operative VTE between patients receiving aspirin-only vs. anticoagulants, controlling for clinical and hospital characteristics using multivariable logistic regression with propensity score adjustment.

Results: Aspirin-only prophylaxis was administered to 7.5% of patients after knee arthroplasty and 8.0% after hip arthroplasty. Post-operative VTE was diagnosed in 2,217 (0.96%) patients after knee arthroplasty and 454 (0.41%) after hip arthroplasty. Compared to anticoagulants, aspirin was not associated with a higher risk for post-operative VTE either after knee arthroplasty (adjusted odds ratio and 95% confidence interval [OR] 0.34 [0.24-0.48]) or hip arthroplasty (OR 0.82 [0.45-1.51]).

Conclusions: Aspirin was not commonly administered as the sole prophylactic agent after hip or knee arthroplasty in this study. Patients who received aspirin-only did not have higher rates of post-operative VTE than patients who received anticoagulants. This study supports the use of aspirin in selected patients undergoing arthroplasty.

To cite this abstract:

Chu, JN; Auerbach, AD; Maselli, J; Fang, MC . THE RISK OF VENOUS THROMBOEMBOLISM WITH ASPIRIN COMPARED TO ANTICOAGULANTS AFTER HIP OR KNEE ARTHROPLASTY. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 72. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/the-risk-of-venous-thromboembolism-with-aspirin-compared-to-anticoagulants-after-hip-or-knee-arthroplasty/. Accessed November 18, 2019.

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