Abstract：
The optimal dosing of aspirin (ASA) monotherapy for prophylaxis after total joint arthroplasty is debatable. The objective of this study was to compare two ASA regimens with regards to symptomatic deep venous thrombosis (DVT), pulmonary embolism (PE), bleeding, and infection 90 days after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).
We retrospectively identified 625 primary THA and TKA surgeries in 483 patients who received ASA for 4 weeks post-op. 301 patients received 325 mg once daily (QD) and 324 patients received 81 mg twice daily (BID). Patients were excluded if they were minors, had a prior venous thromboembolism (VTE), had ASA allergy, or received other VTE prophylaxis drugs.
There was a significant difference in rate of bleeding and suture reactions between the two groups. Bleeding was 7.6% for 325 mg QD and 2.5% for 81 mg BID (p = .0029 Χ2, p = .004 on multivariate logistic regression analysis). Suture reactions were 3.3% for 325 mg QD and 1.2% for 81 mg BID (p = .010 Χ2, p = .027 on multivariate logistic regression analysis). Rates of VTE, symptomatic DVT, and PE were not significantly different. The incidence of VTE was 2.7% for 325 mg QD and 1.5% for 81 mg BID (p = .4056). Symptomatic DVT rates were 1.6% for 325 mg QD and 0.9% for 81 mg BID (p = .4139). Deep infection was 1.0% for 325 mg QD and 0.31% for 81 mg BID (p = .3564).
Low-dose ASA in patients with limited comorbidities undergoing primary THA and TKA is associated with significant lower rates of bleeding and suture reactions than high dose ASA. Low-dose ASA was not inferior to higher dose ASA for the prevention of VTE, wound complications, and infection 90 days postoperatively.
We retrospectively identified 625 primary THA and TKA surgeries in 483 patients who received ASA for 4 weeks post-op. 301 patients received 325 mg once daily (QD) and 324 patients received 81 mg twice daily (BID). Patients were excluded if they were minors, had a prior venous thromboembolism (VTE), had ASA allergy, or received other VTE prophylaxis drugs.
There was a significant difference in rate of bleeding and suture reactions between the two groups. Bleeding was 7.6% for 325 mg QD and 2.5% for 81 mg BID (p = .0029 Χ2, p = .004 on multivariate logistic regression analysis). Suture reactions were 3.3% for 325 mg QD and 1.2% for 81 mg BID (p = .010 Χ2, p = .027 on multivariate logistic regression analysis). Rates of VTE, symptomatic DVT, and PE were not significantly different. The incidence of VTE was 2.7% for 325 mg QD and 1.5% for 81 mg BID (p = .4056). Symptomatic DVT rates were 1.6% for 325 mg QD and 0.9% for 81 mg BID (p = .4139). Deep infection was 1.0% for 325 mg QD and 0.31% for 81 mg BID (p = .3564).
Low-dose ASA in patients with limited comorbidities undergoing primary THA and TKA is associated with significant lower rates of bleeding and suture reactions than high dose ASA. Low-dose ASA was not inferior to higher dose ASA for the prevention of VTE, wound complications, and infection 90 days postoperatively.
摘要：
背景：用于全关节置换术后预防的阿司匹林（ASA）单一疗法的最佳剂量值得商榷。这项研究的目的是比较两种ASA方案对有症状的深静脉血栓形成（DVT）的影响。肺栓塞(PE),出血,初次全髋关节置换术（THA）和全膝关节置换术（TKA）后90天感染。
方法：我们回顾性地确定了483例接受ASA治疗4周的患者中的625例原发性THA和TKA手术。301名患者接受325mg每日一次（QD），324名患者接受81mg每日两次（BID）。如果患者是未成年人，则被排除在外，既往有静脉血栓栓塞(VTE),有ASA过敏,或接受其他VTE预防药物。
结果：两组出血和缝合反应的发生率有显著差异。325mgQD出血为7.6%，81mgBID出血为2.5%(p=.0029X2，p=.004)。325mgQD的缝合反应为3.3%，81mgBID的缝合反应为1.2%（p=.010X2，p=.027）。VTE率,症状性DVT,与PE无显著差异。325mgQD的VTE发生率为2.7％，81mgBID的VTE发生率为1.5％（p=0.4056）。325mgQD的症状性DVT发生率为1.6％，81mgBID的症状性DVT发生率为0.9％（p=0.4139）。325mgQD的深部感染为1.0％，81mgBID的深部感染为0.31％（p=.3564）。
结论：低剂量ASA治疗原发性THA和TKA合并疾病有限的患者，其出血和缝合反应的发生率明显低于高剂量ASA。低剂量ASA对预防VTE的作用不亚于高剂量ASA,伤口并发症,术后90天感染。
方法：我们回顾性地确定了483例接受ASA治疗4周的患者中的625例原发性THA和TKA手术。301名患者接受325mg每日一次（QD），324名患者接受81mg每日两次（BID）。如果患者是未成年人，则被排除在外，既往有静脉血栓栓塞(VTE),有ASA过敏,或接受其他VTE预防药物。
结果：两组出血和缝合反应的发生率有显著差异。325mgQD出血为7.6%，81mgBID出血为2.5%(p=.0029X2，p=.004)。325mgQD的缝合反应为3.3%，81mgBID的缝合反应为1.2%（p=.010X2，p=.027）。VTE率,症状性DVT,与PE无显著差异。325mgQD的VTE发生率为2.7％，81mgBID的VTE发生率为1.5％（p=0.4056）。325mgQD的症状性DVT发生率为1.6％，81mgBID的症状性DVT发生率为0.9％（p=0.4139）。325mgQD的深部感染为1.0％，81mgBID的深部感染为0.31％（p=.3564）。
结论：低剂量ASA治疗原发性THA和TKA合并疾病有限的患者，其出血和缝合反应的发生率明显低于高剂量ASA。低剂量ASA对预防VTE的作用不亚于高剂量ASA,伤口并发症,术后90天感染。
