Aspirin compared to enoxaparin or rivaroxaban for thromboprophylaxis following hip and knee replacement.

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dc.contributor.author Ní Cheallaigh, Sadhbh
dc.contributor.author Fleming, Aoife
dc.contributor.author Dahly, Darren L.
dc.contributor.author Kehoe, Eimear
dc.contributor.author O'Byrne, John M.
dc.contributor.author McGrath, Brid
dc.contributor.author O'Connell, Charles
dc.contributor.author Sahm, Laura J.
dc.date.accessioned 2020-07-15T11:44:20Z
dc.date.available 2020-07-15T11:44:20Z
dc.date.issued 2020-04-23
dc.identifier.citation Ni Cheallaigh, S., Fleming, A., Dahly, D., Kehoe, E., O’Byrne, J. M., McGrath, B., O’Connell, C. and Sahm, L. J. (2020) ‘Aspirin compared to enoxaparin or rivaroxaban for thromboprophylaxis following hip and knee replacement’, International Journal of Clinical Pharmacy, 42, pp. 853-860. doi: 10.1007/s11096-020-01032-1 en
dc.identifier.volume 42 en
dc.identifier.startpage 853 en
dc.identifier.endpage 860 en
dc.identifier.issn 2210-7711
dc.identifier.uri http://hdl.handle.net/10468/10260
dc.identifier.doi 10.1007/s11096-020-01032-1 en
dc.description.abstract Background:The risk of venous thromboembolism following major orthopaedic surgery is among the highest for all surgical specialties. Our hospital guidelines for thromboprophylaxis following elective primary total hip or knee replacement are based on American College of Chest Physicians guidance. The most recent change to local guidelines was the introduction of the extended aspirin regimen as standard thromboprophylaxis. Objective: To establish the appropriateness of this regimen by comparing venous thromboembolism rates in patients receiving extended aspirin to previous regimens. Setting The largest dedicated orthopaedic hospital in Ireland. Methods: This was a retrospective cohort study. Data were collected from patient record software. All eligible patients undergoing primary total hip or knee replacement between 1st January 2010 and 30th June 2016 were included. Main outcome measure Venous thromboembolism up to 6 months post-operatively. Results Of the 6548 participants (55.3% female, mean age 65.4 years (± 11.8 years, 55.8% underwent total hip replacement), venous thromboembolism occurred in 65 (0.99%). Venous thromboembolism rate in both the inpatient enoxaparin group (n = 961) and extended aspirin group (n = 3460) was 1.04% and was 0.66% in the modified rivaroxaban group (n = 1212). Non-inferiority analysis showed the extended aspirin regimen to be equivalent to the modified rivaroxaban regimen. History of venous thromboembolism was the only significant demographic risk factor for post-operative venous thromboembolism (0.87% vs. 3.54%, p  = 0.0002). Conclusion: In daily clinical practice, extended aspirin regimen is at least as effective as modified rivaroxaban for preventing clinically important venous thromboembolism among patients undergoing hip or knee arthroplasty who are discharged from the hospital without complications. Aspirin can be considered a safe and effective agent in the prevention of venous thromboembolism after total hip or total knee replacement. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Springer en
dc.relation.uri https://link.springer.com/article/10.1007/s11096-020-01032-1
dc.rights © 2020 Springer Nature Switzerland AG. This is a post-peer-review, pre-copyedit version of an article published in International Journal of Clinical Pharmacy. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11096-020-01032-1 en
dc.subject Arthroplasty en
dc.subject Aspirin en
dc.subject Enoxaparin en
dc.subject Rivaroxaban en
dc.subject Venous thromboembolism en
dc.title Aspirin compared to enoxaparin or rivaroxaban for thromboprophylaxis following hip and knee replacement. en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Laura J. Sahm, School Of Pharmacy, University College Cork, Cork, Ireland. +353-21-490-3000 Email: l.sahm@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher en
dc.check.date 2021-04-23
dc.date.updated 2020-07-15T11:29:36Z
dc.description.version Published Version en
dc.internal.rssid 512311556
dc.internal.pmid 32328957
dc.description.status Peer reviewed en
dc.identifier.journaltitle International Journal of Clinical Pharmacy en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress l.sahm@ucc.ie en
dc.internal.IRISemailaddress ddahly@ucc.ie en
dc.internal.IRISemailaddress a.fleming@ucc.ie en


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