The Journal of arthroplasty · 2025
Aspirin May Be a Suitable Prophylaxis for Cancer Patients Undergoing Primary Total Knee Arthroplasty.
СтатьяНазвание и аннотация: Перевод в очереди
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Tarabichi Saad, Verhey Jens T, Braithwaite Collin, Hall Rigel P, Lebens Ryan, Christopher Zachary K, Spangehl Mark J, Bingham Joshua S
Аннотация
BACKGROUND: Aspirin is the prophylactic agent of choice for venous thromboembolism prevention in low-risk patients undergoing primary total knee arthroplasty (TKA). However, there remains a paucity of data in the literature on the efficacy of aspirin as a mode of chemoprophylaxis in patients who have a diagnosis of cancer. The purpose of this study was to determine the efficacy of aspirin versus other anticoagulant medications in primary TKA patients who had a diagnosis of active visceral organ malignancy within one year of their arthroplasty procedure.
METHODS: This study utilized a national database to identify patients who underwent primary TKA between 2012 and 2022. Only patients who had a diagnosis code for active visceral organ malignancy within 1 year before their primary TKA were included. Using demographic data, medical comorbidities, and preoperative anticoagulation use, primary TKA patients who have cancer and were prescribed aspirin for thromboprophylaxis (n = 2,833) were propensity score matched on a 1:1 basis to those who were on non-aspirin medications (n = 2,833). The odds ratios (ORs) for developing 90-day medical and surgical complications were determined for patients prescribed aspirin only, when compared to those prescribed other types of chemoprophylaxis.
RESULTS: Patients in the aspirin group had significantly lower odds of developing deep vein thrombosis (1.9 versus 3.2%; OR 0.59 [0.4 to 0.8], P = 0.002) and pulmonary embolism (0.5 versus 1.1%; OR 0.42 [0.2 to 0.8], P = 0.008), when compared to their counterparts in the non-aspirin group. Furthermore, patients prescribed aspirin were significantly less likely to experience an emergency department visit following their procedure (7.9 versus 11.6%; OR 0.65 [0.5 to 0.8], P < 0.001).
CONCLUSION: Based on these findings, aspirin may be a suitable option for venous thromboembolism prophylaxis in patients who have visceral organ cancer who are undergoing primary TKA.
LEVEL OF EVIDENCE: Level III.
METHODS: This study utilized a national database to identify patients who underwent primary TKA between 2012 and 2022. Only patients who had a diagnosis code for active visceral organ malignancy within 1 year before their primary TKA were included. Using demographic data, medical comorbidities, and preoperative anticoagulation use, primary TKA patients who have cancer and were prescribed aspirin for thromboprophylaxis (n = 2,833) were propensity score matched on a 1:1 basis to those who were on non-aspirin medications (n = 2,833). The odds ratios (ORs) for developing 90-day medical and surgical complications were determined for patients prescribed aspirin only, when compared to those prescribed other types of chemoprophylaxis.
RESULTS: Patients in the aspirin group had significantly lower odds of developing deep vein thrombosis (1.9 versus 3.2%; OR 0.59 [0.4 to 0.8], P = 0.002) and pulmonary embolism (0.5 versus 1.1%; OR 0.42 [0.2 to 0.8], P = 0.008), when compared to their counterparts in the non-aspirin group. Furthermore, patients prescribed aspirin were significantly less likely to experience an emergency department visit following their procedure (7.9 versus 11.6%; OR 0.65 [0.5 to 0.8], P < 0.001).
CONCLUSION: Based on these findings, aspirin may be a suitable option for venous thromboembolism prophylaxis in patients who have visceral organ cancer who are undergoing primary TKA.
LEVEL OF EVIDENCE: Level III.