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.
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。