Thromboprophylaxis in orthopedic surgery.

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Abstract

[Indexed for MEDLINE] 13. Open Med (Wars). 2023 Aug 26;18(1):20230760. doi: 10.1515/med-2023-0760. eCollection 2023. Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery. Wei Q(1), Sun J(1), Bai Y(2), Meng C(3), Miao G(4), Liu P(5), Wang H(5). Author information: (1)Department of Critical Care Medicine, Emergency General Hospital, Beijing, 100028, PR China. (2)Department of Vascular Surgery, Chuiyangliu Hospital Affiliated to Tsinghua University, Beijing, 100022, PR China. (3)Department of Emergency, Emergency General Hospital, Beijing, 100028, PR China. (4)Department of Emergency, Emergency General Hospital, XiBaHe South Road 29, Chaoyang District, Beijing, 100028, PR China. (5)Department of Cardiology, Ordos Central Hospital, Ordos School of Clinical Medicine, Inner Mongolia Medical University, 23 Yijinhuoluo West Street, Dongsheng District, Inner Mongolia, 017000, PR China. Low molecular weight heparin (LMWH) is often used to prevent perioperative venous thrombosis after surgery, but aspirin is also recommended by academics. Studies were searched in electronic databases until February 24, 2023. We performed a meta-analysis to evaluate the safety and efficacy of aspirin and LMWH for venous thromboembolism (VTE) prophylaxis in patients after orthopedic surgery. The outcomes were death from any causes, deep vein thrombosis (DVT), pulmonary embolism (PE), etc. This study was registered with INPLASY, number 202320117. Six randomized controlled trials enrolled 13,851 patients with postoperative joint surgery. The risk of DVT was comparable between the two groups when aspirin was combined with mechanical devices (RR 0.61 [95% CI 0.27-1.39], I² = 62%, P = 0.24). No significant differences in all cause death, PE, wound infection, and wound complication were found between the aspirin and LMWH groups. In this meta-analysis, the mortality rate was comparable between the aspirin and LMWH groups. However, aspirin alone had a higher risk of DVT than LMWH. Based on the results of this meta-analysis, we suggest aspirin combined with mechanical devices for VTE prophylaxis in patients after orthopedic surgery. © 2023 the author(s), published by De Gruyter. DOI: 10.1515/med-2023-0760 PMCID: PMC10473459