Aspirin Use for Venous Thromboembolism Prevention Is Safe an
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Venous thromboembolism (VTE), defined as pulmonary embolism (PE) or deep venous thrombosis (DVT), is a rare but serious complication following revision total hip arthroplasty (RTHA) and revision total knee arthroplasty (RTKA). Previous studies show that obesity may be associated with an increased risk for PE, wound complications, and infection. With no current universal standard of care for VTE prophylaxis, researchers sought to determine whether aspirin prescribed (ASA) is safe and effective in obese patients undergoing RTHA/RTKA.

A retrospective review of 1,578 consecutive RTHA/RTKA cases (751 RTHA and 827 RTKA) was conducted identifying patients prescribed 325mg or 81mg ASA. Ninety-day postoperative VTE rates, bleeding, wound complications, deep infections, and mortality were collected. Cohorts were stratified according to body mass index (BMI): normal (18-24.9kg/m2), overweight (25-29.9kg/m2), obese (30-34.9kg/m2), severely obese (35-39.9kg/m2), and morbidly obese (more than40kg/m2).

The cohort comprised of 335 patients with a normal BMI, 511 were overweight, 408 obese, 232 severely obese, and 92 morbidly obese. Total VTE rates were statistically similar between BMI groups (0.90% vs. 0.78% vs. 0.74% vs. 0.43% vs. 0%).
-There were no differences in bleeding rates (0.90% vs. 0% vs. 0% vs. 0.43% vs. 0%),
-wound complications (0.30% vs. 0.20% vs. 0.25% vs. 0% vs. 0%),
-infection (1.49% vs. 1.57% vs. 0.98% vs. 1.29% vs. 1.09%), or mortality (0% vs. 0.20% vs. 0% vs. 0% vs. 0%).

In particular, ASA is safe and effective for VTE prevention in obese patients with similar complication rates to nonobese patients undergoing RTHA/RTKA.