Safety and efficacy of multimodal thromboprophylaxis following total knee arthroplasty: a comparative study of preferential aspirin vs. routine coumadin chemoprophylaxis

Multimodal thromboprophylaxis encompasses preoperative VTE risk stratification, regional anesthesia, mechanical prophylaxis, and early mobilization. We determined if aspirin can be safely used for adjuvant chemoprophylaxis in patients who have a low thromboembolic risk. 1016 consecutive patients und...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of arthroplasty 2013-04, Vol.28 (4), p.575-579
Main Authors: Gesell, Mark W, González Della Valle, Alejandro, Bartolomé García, Sergio, Memtsoudis, Stavros G, Ma, Yan, Haas, Steven B, Salvati, Eduardo A
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Arthroplasty, Replacement, Knee - adverse effects
Aspirin - adverse effects
Aspirin - therapeutic use
Chemoprevention
Drug Therapy, Combination
Female
Fibrinolytic Agents - adverse effects
Fibrinolytic Agents - therapeutic use
Humans
Male
Middle Aged
Retrospective Studies
Thromboembolism - etiology
Thromboembolism - prevention & control
Warfarin - adverse effects
Warfarin - therapeutic use
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Multimodal thromboprophylaxis encompasses preoperative VTE risk stratification, regional anesthesia, mechanical prophylaxis, and early mobilization. We determined if aspirin can be safely used for adjuvant chemoprophylaxis in patients who have a low thromboembolic risk. 1016 consecutive patients undergoing TKA received multimodal thromboprophylaxis. Aspirin was used in 67% of patients and Coumadin 33% (high risk patients, or who were on Coumadin before surgery). This study group was compared to 1001 consecutive patients who received multimodal thromboprophylaxis and routine Coumadin chemoprophylaxis. There was no significant difference in rates of VTE, PE, bleeding, complications, readmission and 90-day mortality between the two groups. There was a significantly higher rate of wound related complications in the control group (p=0.03). Multimodal thromboprophylaxis with aspirin given to the majority of patients at a low VTE risk is safe and effective in patients undergoing primary TKA.
ISSN:1532-8406
DOI:10.1016/j.arth.2012.08.004