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Drugs & Therapy Perspectives

, Volume 35, Issue 1, pp 36–42 | Cite as

Comparison between aspirin 325 mg and enoxaparin 40 mg as extended thromboprophylactic agents following major orthopedic surgery in Jordan University Hospital

  • Mariam Ahmed AlamiriEmail author
  • Abla Mahmoud Albsoul-Younes
  • Jihad Moh’d Said Al-Ajlouni
Short Communication

Abstract

Background

Major orthopedic surgeries include total or partial hip replacement, total knee replacement and hip fracture surgeries. These surgeries are considered to have a high risk for the development of venous thromboembolism (VTE).

Objective

This study was carried out to compare the clinical outcomes of aspirin (acetylsalicylic acid) and enoxaparin as thromboprophylaxis agents following major orthopedic surgery.

Methods

A prospective cohort study was conducted at one tertiary hospital in Amman, Jordan, between October 2014 and March 2015. One hundred and seventy patients were enrolled in the study after completion of the informed consent form. A follow-up period of up to 35 days was started immediately after the surgery date. According to surgeon experience and patients’ risk factors, extended VTE prophylaxis was prescribed as enoxaparin 40 mg daily in 31.8% of patients (54/170) and as aspirin 325 mg daily in 68.2% of patients (116/170).

Results

Compliance with treatment was significantly higher with aspirin than with enoxaparin (97.4 vs. 75.9% of patients; p = 0.003). Significantly more enoxaparin than aspirin recipients experienced symptomatic VTE (16.7 vs. 5.2%; p = 0.014) and had bleeding (11.1 vs. 2.5%; p = 0.018).

Conclusion

Aspirin represents a safe and effective choice for extended VTE prophylactic in low-risk patients, as it is effective (for a mean duration of 1 month), safe, associated with high compliance rates, and is less expensive than other options.

Notes

Acknowledgements

The authors’ thanks and appreciation go to the orthopedic staff of the Jordan University Hospital for their cooperation, and special thanks goes to Mr. Mahmmoud Ahmad Fahjan, a physiotherapist, for giving such attention and time.

Compliance with ethical standards

Conflict of interest

The authors have no relevant conflicts of interest.

Ethics approval

The study was approved by the institutional review board of the Jordan University Hospital.

Informed consent

All study participants provided informed consent.

Funding

None to declare.

References

  1. 1.
    Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2):e278S–325S.CrossRefGoogle Scholar
  2. 2.
    Parry M, Wylde V, Blom AW. Ninety-day mortality after elective total hip replacement: 1549 patients using aspirin as a thromboprophylactic agent. J Bone Jt Surg Br. 2008;90(3):306–7.CrossRefGoogle Scholar
  3. 3.
    Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2008;133(6):381S–453S.CrossRefGoogle Scholar
  4. 4.
    Stewart DW, Freshour JE. Aspirin for the prophylaxis of venous thromboembolic events in orthopedic surgery patients: a comparison of the AAOS and ACCP guidelines with review of the evidence. Ann Pharmacother. 2013;47(1):63–74.CrossRefGoogle Scholar
  5. 5.
    Hill J, Treasure T. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital: summary of the NICE guideline. Heart. 2010;96(11):879–82.CrossRefGoogle Scholar
  6. 6.
    Mistry DA, Chandratreya A, Lee PYF. A systematic review on the use of aspirin in the prevention of deep vein thrombosis in major elective lower limb orthopedic surgery: an update from the past 3 years. Surg J (N Y). 2017;3(4):e191–6.Google Scholar
  7. 7.
    Lassen MR, Ageno W, Borris LC, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med. 2008;358(26):2776–86.CrossRefGoogle Scholar
  8. 8.
    Lieberman JR. The new AAOS clinical practice guidelines on venous thromboembolic prophylaxis: how to adapt them to your practice. JAAOS. 2011;19(12):717–21.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Biopharmaceutics and Clinical Pharmacy, School of PharmacyThe University of JordanAmmanJordan
  2. 2.Department of OrthopaedicsUniversity of JordanAmmanJordan
  3. 3.Orthopaedic SurgeryUniversity of Jordan HospitalAmmanJordan
  4. 4.Faculty of MedicineUniversity of JordanAmmanJordan

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