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. 2023 Nov 23;18(1):894.
doi: 10.1186/s13018-023-04374-4.

The impact of long-term aspirin use on the patients undergoing shoulder arthroplasty

Xiuhua Mao #  1 , Chen Liang #  2 , Xiaoqin Li #  2 , Danping Shi  3 , Qinfeng Yang  2 , Hao Xie  4 , Fangguo Liang  5 , Yuhui Cui  6
Affiliations

The impact of long-term aspirin use on the patients undergoing shoulder arthroplasty

Xiuhua Mao et al. J Orthop Surg Res. .

Abstract

Background: Although aspirin is increasingly utilized to reduce the event of severe perioperative complications, the effect of long-term aspirin use (L-AU) on perioperative complications in patients undergoing shoulder arthroplasty (SA) has not been well studied. The goal of the present study is to identify the influence of L-AU on perioperative complications in individuals undergoing SA.

Methods: We selected data from the National Inpatient Sample database between 2010 and 2019, to identify adult patients with SA. Patients were subsequently categorized into L-AU and whole non-L-AU cohorts according to the presence of aspirin use. The demographic and comorbidity characteristics were matched using propensity score matching (PSM). The Pearson chi-square test, Wilcoxon rank test and logistic regression were utilized to assess the association of L-AU with perioperative complications.

Results: From 2010 to 2019, a total of 162,418 SA patients satisfied the inclusion criteria, with 22,659 (13.95%) using aspirin on a long-term basis. The vast majority of the patients with pre-existing L-AU were aged 65-74 years, female, White and had Medicare insurance. L-AU before surgery was linked to increased risks of perioperative complications, such as blood transfusion (adjusted odds ratio [aOR]: 1.339), genitourinary disease (aOR: 1.349), acute renal failure (aOR: 1.292), acute myocardial infarction (aOR: 1.494), higher total charge (L-AU vs. the whole non-L-AU vs. matched non-L-AU: $66,727.15 vs. $59,697.08 vs. $59,926.32), and prolonged hospitalization stay (LOS) (aOR: 0.837). However, L-AU was considered a protective factor of acute cerebrovascular disease (aOR: 0.722) and stroke (aOR: 0.725).

Conclusions: Our study is based on the largest open-access all-payer inpatient database, revealing a noteworthy finding of aspirin's protective and adverse impact on different postoperative complications in the US population, such as acute cardiovascular disease, and stroke, etc. Further studies assessing the optimum preoperative aspirin duration and dosage to meet the best benefit quantity for patients with planned joint arthroplasties are suggested.

Keywords: Aspirin; Complication; National Inpatient Sample database; Shoulder arthroplasty.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Analysis plan
Fig. 2
Fig. 2
The annual popularity of pre-existing long-term aspirin use in patients undergoing shoulder arthroplasty between 2010 and 2019 in the United States
See this image and copyright information in PMC

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