Aspirin for thromboprophylaxis in orthopedic surgery: advancements in clinical evidence and guidelines
10.3760/cma.j.cn115530-20230818-00069
- VernacularTitle:阿司匹林用于骨科术后静脉血栓栓塞症预防——临床证据进展与指南的变化
- Author:
Anhua LONG
1
;
Yakui ZHANG
Author Information
1. 首都医科大学附属北京潞河医院创伤骨科，北京 101100
- Keywords:
Aspirin;
Pulmonary embolism1;
Anticoagulants;
Deep vein thrombosis
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(2):180-184
- CountryChina
- Language:Chinese
-
Abstract:
As patients undergoing orthopedic surgery are a high-risk group for venous thromboembolism (VTE), clinical guidelines suggest anticoagulant drugs for VTE prophylaxis during perioperative period. Global antithrombotic guidelines vary in recommendations for anticoagulant drugs, but there is a general consensus in favor of using low-molecular-weight heparin (LMWH) as the first choice for prophylaxis, followed by unfractionated heparin, fondaparinux, warfarin, aspirin, and other direct oral anticoagulants (DOACs). Of them, aspirin is an inexpensive, widely used antiplatelet drug with limited complications and clear efficacy in prevention of myocardial infarction, stroke, and certain specific cancers. It was also used early for venous thromboembolism prophylaxis in orthopedic patients after surgery. Clinical experience of orthopedic physicians in North America has shown the effectiveness of aspirin in VTE prevention over several decades so that aspirin continues to be used to this day, but its use for VTE prophylaxis is less common in Europe and Asia. Historically, the role and efficacy of aspirin in VTE prevention have been the subjects of considerable controversy, for the early and recent research findings contradict each other, and recommendations conflict in different guidelines. This review focuses on the advancements in clinical evidence and guideline recommendations regarding the use of aspirin for VTE prophylaxis in major orthopedic surgeries.
