Journal article
Weight-Based Aspirin Dosing May Further Reduce the Incidence of Venous Thromboembolism Following Primary Total Joint Arthroplasty
The Journal of arthroplasty, Vol.36(12), pp.3986-3992.e1
12/2021
DOI: 10.1016/j.arth.2021.06.008
PMID: 34215460
Abstract
Obesity poses a challenge to thromboembolic prophylaxis following total joint arthroplasty (TJA). The purpose of this study is to evaluate a weight-based aspirin dosing regimen for prevention of venous thromboembolism (VTE) following TJA.
This is a retrospective observational study of 2403 patients who underwent primary total hip or knee arthroplasty at one institution. A weight-based aspirin dosing regimen for VTE prophylaxis was administered to 1247 patients: patients weighing ≥120 kg received 325 mg aspirin twice daily (BID) and those weighing <120 kg received 81 mg aspirin BID for 4 weeks. In total, 1156 patients in the comparison cohort received 81 mg aspirin BID. VTE and gastrointestinal bleeding events were identified through chart review at 42 days and 6 months postoperatively. A multivariable logistic regression was performed to adjust for covariates.
The weight-based aspirin cohort had a significantly lesser incidence of VTE at 42 days (P = .03, relative risk [RR] 0.31, 95% confidence interval 0.12-0.82) and 6 months (P = .03, RR 0.38, 95% confidence interval 0.18-0.80). There was no difference in VTE incidence between total hip arthroplasty and total knee arthroplasty cases (P = .8). There was no difference in gastrointestinal bleeding events between the cohorts at 42 days (P = .69) or 6 months (P = .92). Subanalysis of patients weighing ≥120 kg demonstrated a significant difference between the cohorts with a VTE incidence of 3.48% and 0% in the 81 mg and weight-based cohorts, respectively (P = .02).
Patients prescribed a weight-based aspirin regimen had significantly fewer VTEs after TJA compared to historical controls with an RR reduction of 69% at 6 weeks and 62% at 6 months postoperatively. This suggests the need to factor patient weight when determining postoperative VTE prophylaxis with aspirin.
Details
- Title: Subtitle
- Weight-Based Aspirin Dosing May Further Reduce the Incidence of Venous Thromboembolism Following Primary Total Joint Arthroplasty
- Creators
- Christopher R. Halbur - University of Iowa Hospitals and ClinicsTrevor R. Gulbrandsen - University of IowaChristopher R. West - Washington University in St. LouisTimothy S. Brown - University of IowaNicolas O. Noiseux - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.36(12), pp.3986-3992.e1
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.arth.2021.06.008
- PMID
- 34215460
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Grant note
- DOI: 10.13039/100015515, name: University of Iowa Roy J and Lucille A Carver College of Medicine
- Language
- English
- Date published
- 12/2021
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303979502771
Metrics
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