Risk‐Stratified Venous Thromboembolism Prophylaxis after Total Joint Arthroplasty: Low Molecular Weight Heparins and Sequential Aspirin vs Aggressive Chemoprophylaxis

• DOI: 10.1111/os.12926
• Publication Date: 2021-01-15T23:15:57Z
• Authors: Hui‐ming Peng; Xi Chen; Yi‐ou Wang; Yan‐yan Bian; Bin Feng; Wei Wang; Xi‐sheng Weng; Wen‐wei Qian
• Keywords: Chemoprophylaxis; Medical record

Objective Venous thromboembolism (VTE) is a significant concern post total joint arthroplasty (TJA). However, the optimal prevention method of VTE remains controversial at present. This study aims to evaluate risk‐stratified prophylaxis protocol for patients undergoing TJA. Methods A 891 TJA from January 2011 November 2019 were retrospectively investigated. The was divided into two cohorts. In cohort 1, 410 (250 females and 160 males, mean age 64.32 years) treated with an aggressive chemoprophylaxis protocol. 2, 481 that utilized low molecular weight heparins (LMWH) sequential aspirin (ASA) standard‐risk (a 288 containing 177 111 65.4 years), targeted anticoagulation high‐risk 193 121 72 66.8 years). followed up 2–4 weeks initial visit 6–10 subsequent after surgery. chart review all patient medical records performed record demographics, comorbidities, deep vein thrombosis, pulmonary embolus, superficial infection, bleeding complications, 90‐day readmissions. Results rate 1.71% (7/410) in 1 1.46% (7/481) 2 respectively. For 2.07% (4/193) group 1.04% (3/288) group. readmission 2.44% (10/410) 2.08% (10/481) 2. (6/288) reasons as follows: 1.3% (5/410) (6/481) 2; wound or 0.48% (2/410) 0.2% (1/481) trauma, (1/410) VTE, others, 0.6% (3/481) There decrease events readmissions cohort, although this did not reach statistical significance. it found there reduction costs ( P < 0.001) use LMWH/ASA, when compared agents cohort. Conclusion LMWH/ASA population safe cost‐effective prophylaxis.