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Low-dose aspirin and the rate of symptomatic venous thromboembolic complications following primary shoulder arthroplasty
- Source :
- Journal of Shoulder and Elbow Surgery. 30:1613-1618
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Venous thromboembolism (VTE) events are infrequent but potentially catastrophic complications following orthopedic surgery. There is currently a paucity of evidence regarding the role of chemoprophylaxis with low-dose aspirin (acetylsalicylic acid [ASA]) after shoulder arthroplasty.We conducted a retrospective review of prospectively collected complications occurring within 90 days of 2394 primary shoulder arthroplasties performed over a 3-year period at a single institution. Patients preoperatively underwent risk stratification into medically high risk, moderate risk, or low risk as part of a standardized navigated-care pathway. For chemoprophylaxis, 81 mg of ASA (low dose) was routinely used once daily for 6 weeks unless alternative medications were deemed necessary by the medical team. Baseline demographic information, medical comorbidities, and postoperative VTE prophylaxis, as well as rates of clinically symptomatic VTE, were assessed.Symptomatic VTE occurred after 0.63% of primary shoulder arthroplasties (15 of 2394). There were 9 patients with deep vein thromboses and 6 with pulmonary embolisms. Eighty-one milligrams of ASA was used in 2141 patients (89.4%), resulting in an overall VTE rate of 0.56%. Medically high-risk patients were significantly more likely to have a VTE (P = .018). Patients with a history of deep vein thrombosis, asthma, and cardiac arrhythmia were significantly more likely to have a VTE (P.05). Complications occurred in 4 patients (0.19%) associated with low-dose ASA and 1 patient (0.63%) associated with a novel oral anticoagulant medication.Routine use of low-dose ASA results in a very low risk of VTE and medication-associated complications following primary shoulder arthroplasty. Preoperative medical risk stratification can potentially identify patients at high risk of postoperative VTE.
- Subjects :
- medicine.medical_specialty
Deep vein
medicine.medical_treatment
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Humans
Medicine
Orthopedics and Sports Medicine
cardiovascular diseases
Retrospective Studies
Asthma
030222 orthopedics
Aspirin
business.industry
Incidence
Venous Thromboembolism
030229 sport sciences
General Medicine
medicine.disease
Arthroplasty
Thrombosis
Surgery
Pulmonary embolism
medicine.anatomical_structure
Arthroplasty, Replacement, Shoulder
Orthopedic surgery
Chemoprophylaxis
Pulmonary Embolism
business
medicine.drug
Subjects
Details
- ISSN :
- 10582746
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Journal of Shoulder and Elbow Surgery
- Accession number :
- edsair.doi.dedup.....de9c5ec32ec0a3ca7d5d3552db01cd1c