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

dc.check.date2021-04-23
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisheren
dc.contributor.authorNí Cheallaigh, Sadhbh
dc.contributor.authorFleming, Aoife
dc.contributor.authorDahly, Darren L.
dc.contributor.authorKehoe, Eimear
dc.contributor.authorO'Byrne, John M.
dc.contributor.authorMcGrath, Brid
dc.contributor.authorO'Connell, Charles
dc.contributor.authorSahm, Laura J.
dc.date.accessioned2020-07-15T11:44:20Z
dc.date.available2020-07-15T11:44:20Z
dc.date.issued2020-04-23
dc.date.updated2020-07-15T11:29:36Z
dc.description.abstractBackground: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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationNi 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/s11096-020-01032-1en
dc.identifier.doi10.1007/s11096-020-01032-1en
dc.identifier.endpage860en
dc.identifier.issn2210-7711
dc.identifier.journaltitleInternational Journal of Clinical Pharmacyen
dc.identifier.startpage853en
dc.identifier.urihttps://hdl.handle.net/10468/10260
dc.identifier.volume42en
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urihttps://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/s11096-020-01032-1en
dc.subjectArthroplastyen
dc.subjectAspirinen
dc.subjectEnoxaparinen
dc.subjectRivaroxabanen
dc.subjectVenous thromboembolismen
dc.titleAspirin compared to enoxaparin or rivaroxaban for thromboprophylaxis following hip and knee replacement.en
dc.typeArticle (peer-reviewed)en
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