Key result
Low-molecular-weight heparin and warfarin increased the odds of venous thromboembolism compared with aspirin in total joint arthroplasty, and warfarin increased joint infection (p<0.001).
Why the study?
Potent agents are commonly used for total joint arthroplasty patients at higher venous thromboembolism risk, but no studies had investigated their efficacy in this population.
Does low-molecular-weight heparin or warfarin reduce venous thromboembolism compared to aspirin in high-risk patients undergoing total joint arthroplasty?
Observational (n=60,467)
Yes
Does low-molecular-weight heparin or warfarin reduce venous thromboembolism compared to aspirin in high-risk patients undergoing total joint arthroplasty?
p-value: p=<0.001
Aspirin appears to be as effective as or more effective than potent anticoagulation (warfarin or low-molecular-weight heparin) for VTE prophylaxis in high-risk patients undergoing total joint arthroplasty, while potentially avoiding increased infection risks.
No takes yet. Share an insight, caveat, or question.
Aspirin may suffice for VTE prophylaxis in high-risk total joint arthroplasty; hypothesis-generating and requires randomized confirmation before practice change.
Tan et al. (2019) conducted an observational in Primary and revision total joint arthroplasties (n=60,467). Low-molecular-weight heparin and warfarin vs. Aspirin was evaluated on 90-day rate of symptomatic venous thromboembolism and periprosthetic joint infection (p=<0.001). Low-molecular-weight heparin and warfarin increased the odds of venous thromboembolism compared with aspirin in total joint arthroplasty, and warfarin increased joint infection (p<0.001).
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