The Efficacy and Related Complications of Low Dose Aspirin in Preventing Vte After Primary Joint

Shuang Fuhang; Lu Ning; Tang Hao; Hu Jianbang; Fang Shaoran; Li Wenjin; Yang Tingdong; Huangfu Wenfei; Xu Wente

Abstract：Objective To compare the efficacy,safety,and complications of aspirin versus low molecular-weight heparin(LMWH)in preventing venous thromboembolism(VTE)after primary joint arthroplasty.Methods A retrospective analysis was conducted on 1 160 patients who underwent primary hip or knee arthroplasty at the Department of Orthopaedics,the Second Affiliated Hospital of Kunming Medical University,from July 2013 to August 2022.The study included 755 hip arthroplasties and 405 knee arthroplasties.There were 381 males(32.8％)and 779 females(67.2％),with a mean age of(67.6±13.1)years(range,23～98 years).All patients received conventional VTE prophylaxis starting within 12～24 hours postoperatively,continuing for 30 days.The LMWH group comprised 853 patients(73.5％)receiving subcutaneous LMWH(4 000 IU/d),while the aspirin group included 307 patients(26.5％)taking oral aspirin(100 mg/d).Data recorded during follow-up included symptomatic VTE,major bleeding events,mortality,cardiovascular and cerebrovascular events,infections,postoperative blood transfusion volume,hemoglobin decline,reoperation for incision nonunion,drainage volume,and hospital stay.Results All patients were followed up for≥90 days.Postoperative VTE occurred in 13 LMWH-group patients(1.5％)and 6 aspirin-group patients(2.0％),with no significant between-group difference(P＞0.05).Postoperative bleeding events were reported in 3 LMWH-group patients(0.4％)and 1 aspirin-group patient(0.3％),also showing no significant difference(P＞0.05).The LMWH group exhibited a greater postoperative hemoglobin decline than the aspirin group[(27.9±18.7)g/L vs.(22.6±16.6)g/L,P＜0.00 1].Similarly,postoperativedrainagevolume[195(100,313)mLvs.130(60,240)mL,P＜0.001]and average hospital stay[12(8,15)days vs.8(7,13)days,P＜0.001]were significantly higher in the LMWH group.No significant differences were observed in other outcomes,including mortality,cardiovascular/cerebrovascular events,infections,blood transfusions,and reoperations for incision nonunion(P＞0.05).Conclusion Low-dose aspirin is an effective and safe VTE prophylaxis option after primary joint arthroplasty.Compared to LMWH,it significantly reduces postoperative blood loss,shortens hospitalization,and decreases drainage volume.