Clinical efficacy of risk-stratified prophylaxis with low-dose aspirin for the management of symptomatic venous thromboembolism after total hip arthroplasty

Mihara, Masahiko; Tamaki, Yasuhiro; Nakura, Nariaki; Takayanagi, Shunsaku; Saito, Akira; Ochiai, Shunsuke; Hirakawa, Kazuhiko

doi:10.1016/j.jos.2019.02.009

Cited by 9 publications

(13 citation statements)

References 26 publications

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“…The subjects of this study are elderly patients 50 years and older. The elasticity of blood vessels are poor and elder patients are complicated by the physiological or organic changes of multiple organs, and the perioperative period of lower extremity joint mobility and the amount of activity are significantly reduced, so the risk of DVT is higher[ 24 – 26 ]. We have found that age > 70y, BMI ≥ 28, diabetes, bilateral joint replacements, duration of surgery ≥ 120 min, cemented prosthesis, and duration of days in bed > 3 days were the independent risk factors of DVT of lower limb in patients with THA.…”

Section: Discussionmentioning

confidence: 99%

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

Ning

2021

BMC Musculoskelet Disord

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Background Deep vein thrombosis (DVT) of lower limb is one of the common complications after total hip arthroplasty(THA), we aimed to evaluate the potential risk factors of DVT of lower limb in patients with THA, to provide insights into the management of THA. Methods Patients who underwent THA in our hospital from January 1, 2017 to November 30, 2020 were included. The personal characteristics and clinical data of DVT and no-DVT patients were compared and analyzed. Logistic regression analyses were perfomed to identify the potential risk factors of DVT in patients with THA. Results A total of 182 THA patients were included, the incidence of DVT of lower limb in patients with THA was 19.78 %. There were significant differences in the age, BMI, diabetes, number of replacement, duration of surgery, type of prosthesis and duration of days in bed between DVT and no-DVT patients(all P < 0.05). And there were no significant differences in the gender, hypertension, hyperlipidemia, preoperative D-dimer, type of anesthesia and anticoagulant drugs use(all P > 0.05). Logistic regression analysis indicated that age > 70y(OR4.406, 95 %CI1.744 ~ 6.134), BMI ≥ 28(OR2.275, 95 %CI1.181 ~ 4.531), diabetes(OR3.949, 95 %CI1.284 ~ 5.279), bilateral joint replacements(OR2.272, 95 %CI1.402 ~ 4.423), duration of surgery ≥ 120 min(OR3.081, 95 %CI1.293 ~ 5.308), cemented prosthesis(OR2.435, 95 %CI1.104 ~ 4.315), and duration of days in bed > 3 days(OR1.566, 95 %CI1.182 ~ 1.994) were the risk factors of DVT of lower limb in patients with THA. Conclusions DVT in the lower limb after THA is common, and its onset is affected by many factors. In clinical work, attention should be paid to identify the risk factors for DVT and targeted interventions are highlighted to prevent the postoperative DVT.

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Section: Discussionmentioning

confidence: 99%

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

Ning

2021

BMC Musculoskelet Disord

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“…Mihara et al [ 74 ] performed a retrospective study of DVT prophylaxis using low-dose aspirin in patients who underwent THA. The patients were divided into a low-risk VTE group and a high-risk VTE group [ 74 ]. Low-risk patients received aspirin for 28 days postoperatively [ 74 ].…”

Section: Statements Of Group 3: Pharmacological Venous Thromboembolism Prophylaxismentioning

confidence: 99%

“…The patients were divided into a low-risk VTE group and a high-risk VTE group [ 74 ]. Low-risk patients received aspirin for 28 days postoperatively [ 74 ]. High-risk patients, such as those diagnosed with obesity and/or with a history of VTE, received anticoagulants (enoxaparin or edoxaban) for five days postoperatively, followed by 100 mg/day of aspirin for 28 days [ 74 ].…”

Section: Statements Of Group 3: Pharmacological Venous Thromboembolism Prophylaxismentioning

confidence: 99%

“…Low-risk patients received aspirin for 28 days postoperatively [ 74 ]. High-risk patients, such as those diagnosed with obesity and/or with a history of VTE, received anticoagulants (enoxaparin or edoxaban) for five days postoperatively, followed by 100 mg/day of aspirin for 28 days [ 74 ]. There was a low incidence of symptomatic DVT and PE [ 74 ].…”

Section: Statements Of Group 3: Pharmacological Venous Thromboembolism Prophylaxismentioning

confidence: 99%

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Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 3. Pharmacological venous thromboembolism prophylaxis

Thiengwittayaporn

Budhiparama

Tanavalee

et al. 2021

Knee Surg & Relat Res

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“…Furthermore, low-dose 81-mg ASA given twice daily has shown to be as effective as higher dose of 325-mg ASA [6]. Those patients with a higher risk profile including obesity and/or history of VTE are still commonly recommended to have a stronger prophylaxis rather than ASA [14,15].…”

Section: Introductionmentioning

confidence: 99%

Ambulatory Portable Pneumatic Compression Device as Part of a Multimodal Aspirin-Based Approach in Prevention of Venous Thromboembolism in Outpatient Total Knee Arthroplasty

et al. 2020

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Background: The purpose of this study is to review the incidence of symptomatic venous thromboembolism (VTE) in patients undergoing outpatient primary total knee arthroplasty (TKA) who used a portable pneumatic compression device as part of their VTE prophylaxis protocol. Methods: A retrospective review of all outpatient primary TKA procedures in which patients used ambulatory pneumatic compression pumps as part of their multimodal VTE prophylaxis was performed from 2016 through 2018. This yielded a cohort of 1131 patients (1453 TKAs). An aspirin (ASA)-based protocol was used in patients with standard VTE risk receiving either 81 mg or 325 mg of ASA twice daily for 6 weeks postoperatively. High-risk patients received a stronger chemoprophylaxis for 2 weeks followed by ASA for 4 weeks. Pneumatic compression pumps were worn for 23 hours/day for 14 days. Results: VTE prophylaxis medication was 81-mg ASA in 56% of patients, 325-mg ASA in 10% of patients, and stronger chemoprophylaxis in 34% of patients. Patients were considered morbidly obese (body mass index >40 kg/m 2) in 267 (18.4%) procedures. Ninety-seven (6.7%) patients had a preoperative history of VTE event. Forty-nine duplex ultrasounds were performed (3.3% of TKAs). Confirmed VTE events were documented in only 5 (0.3%) patients. All VTEs occurred in high-risk patients who were discharged on stronger chemoprophylaxis. The time (days) to VTE was 3, 3, 7, 45, and 88 days. Conclusions: The use of portable pneumatic compression pumps as part of a multimodal VTE prophylaxis protocol aided in a very low rate of symptomatic VTE events in patients undergoing outpatient primary TKA.

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Clinical efficacy of risk-stratified prophylaxis with low-dose aspirin for the management of symptomatic venous thromboembolism after total hip arthroplasty

Cited by 9 publications

References 26 publications

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 3. Pharmacological venous thromboembolism prophylaxis

Ambulatory Portable Pneumatic Compression Device as Part of a Multimodal Aspirin-Based Approach in Prevention of Venous Thromboembolism in Outpatient Total Knee Arthroplasty

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