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Review
. 2023 Aug 26;18(1):20230760.
doi: 10.1515/med-2023-0760. eCollection 2023.

Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery

Qingqing Wei  1 , Jing Sun  1 , Yusuo Bai  2 , Chang Meng  3 , Guobin Miao  4 , Peng Liu  5 , Haijun Wang  5
Affiliations
Review

Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery

Qingqing Wei et al. Open Med (Wars). .

Abstract

Low molecular weight heparin (LMWH) is often used to prevent perioperative venous thrombosis after surgery, but aspirin is also recommended by academics. Studies were searched in electronic databases until February 24, 2023. We performed a meta-analysis to evaluate the safety and efficacy of aspirin and LMWH for venous thromboembolism (VTE) prophylaxis in patients after orthopedic surgery. The outcomes were death from any causes, deep vein thrombosis (DVT), pulmonary embolism (PE), etc. This study was registered with INPLASY, number 202320117. Six randomized controlled trials enrolled 13,851 patients with postoperative joint surgery. The risk of DVT was comparable between the two groups when aspirin was combined with mechanical devices (RR 0.61 [95% CI 0.27-1.39], I² = 62%, P = 0.24). No significant differences in all cause death, PE, wound infection, and wound complication were found between the aspirin and LMWH groups. In this meta-analysis, the mortality rate was comparable between the aspirin and LMWH groups. However, aspirin alone had a higher risk of DVT than LMWH. Based on the results of this meta-analysis, we suggest aspirin combined with mechanical devices for VTE prophylaxis in patients after orthopedic surgery.

Keywords: aspirin; joint surgery; low-molecular-weight heparin; venous thromboembolism.

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Conflict of interest statement

Conflict of interest: Authors state no conflict of interest.

Figures

Figure 1
Figure 1
The flow chart of the search and study selection process.
Figure 2
Figure 2
The outcomes of all cause death.
Figure 3
Figure 3
The outcomes of PE.
Figure 4
Figure 4
The outcomes of wound infection.
Figure 5
Figure 5
The outcomes of DVT.
Figure 6
Figure 6
The outcomes of wound complication.
Figure A1
Figure A1
Risk of bias graph.
See this image and copyright information in PMC

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