What is the clinical evidence from this study?

Study design: Cohort. Population: Elective total hip arthroplasty (n=8885). Intervention: Aspirin. Primary outcome: Symptomatic venous thromboembolism (DVT and PE) within six months.

March 21, 2023CureusOpen Access

Incidence of Symptomatic Venous Thromboembolism (VTE) in 8,885 Elective Total Hip Arthroplasty Patients Receiving Post-operative Aspirin VTE Prophylaxis

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Key result

An aspirin-based VTE prophylaxis protocol in patients undergoing elective total hip arthroplasty resulted in an overall symptomatic VTE incidence of 1.11% within six months.

Why the study?

Venous thromboembolism is a reducible cause of morbidity and mortality after elective hip arthroplasty, requiring balance between prophylaxis and post-operative haemorrhage risk.

Does aspirin prophylaxis prevent symptomatic VTE in patients undergoing elective total hip arthroplasty?

Population

8,885 patients undergoing elective THA at a single institution

Comparison

Aspirin-based thromboprophylaxis

Design

Single-centre prospective cohort study

Follow-up

Six months

Authors

ECEamonn CoveneyConnolly Hospital Blanchardstown CHChristopher HuttonRoyal Devon & Exeter NHS Foundation Trust NPNimesh S. A. PatelWilliam Harvey Research Institute

Discussion

Member takes

Implication

May support aspirin prophylaxis in elective THA; leaves open need for RCTs to confirm efficacy.

Study Design

Type

Cohort (n=8,885)

Multicenter

Structured PICO

Does aspirin prophylaxis prevent symptomatic VTE in patients undergoing elective total hip arthroplasty?

Population

8,885 patients undergoing elective primary or revision total hip arthroplasty receiving aspirin-based VTE prophylaxis, followed for 6 months.

Exposure

Aspirin 150 mg oral once daily for six weeks on hospital discharge (with intermittent calf compression stockings and prophylactic low molecular weight heparin during inpatient stay from 2005 onwards, or aspirin only prior to 2005).

Outcome

Incidence of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) occurring within six months of the index operationhard clinical

Aspirin is an effective, safe, and inexpensive primary pharmacological prophylaxis against symptomatic VTE following elective total hip arthroplasty, with a low 1.11% VTE incidence.

Limitations

Incomplete data resulting in the exclusion of 17.7% of patients.
Deaths were not checked with the national death register, relying instead on hospital systems linked to General Practitioner databases.
Lack of a direct control group or randomization.
Incomplete data resulting in exclusion of 17.7% of patients
Deaths were not checked with the national death register, relying instead on hospital systems linked to General Practitioner databases

Cite This Study

Coveney et al. (2023) conducted a cohort in Elective total hip arthroplasty (n=8,885). Aspirin was evaluated on Symptomatic venous thromboembolism (DVT and PE) within six months. An aspirin-based VTE prophylaxis protocol in patients undergoing elective total hip arthroplasty resulted in an overall symptomatic VTE incidence of 1.11% within six months.

synapsesocial.com/papers/6a82f370b9768edacab378d9 https://doi.org/10.7759/cureus.36464

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