Weight-Based Aspirin Dosing May Further Reduce the Incidence of Venous Thromboembolism Following Primary Total Joint Arthroplasty

Halbur, Christopher; Gulbrandsen, Trevor R.; West, Christopher R.; Brown, Timothy S.; Noiseux, Nicolas

doi:10.1016/j.arth.2021.06.008

Cited by 9 publications

(6 citation statements)

References 45 publications

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“…In clinical outcome‐observed studies, previous randomized trials 16 have shown that low‐dose (75–100 mg) aspirin in reducing the risks of vascular events and cancer was modified by body weight. And patients taking weight‐based aspirin may have a reduced incidence of venous thromboembolism following primary total joint arthroplasty 17 . Similarly, in this retrospective study, we observed that body weight was related to bleeding adverse events of aspirin, and patients with low body weight seemed to be at a high risk of bleeding.…”

Section: Resultssupporting

confidence: 55%

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Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Wang

Zhu

et al. 2022

Clinical Pharmacy Therapeu

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What is known and objectives Bleeding is the most common adverse reaction to aspirin and can lead to drug discontinuation or even be life‐threatening in the secondary prevention of stroke or transient ischemic attack. The aim of this study was to evaluate risk factors for bleeding adverse reaction of aspirin in ischemic stroke or transient ischemic attack. Methods This retrospective analysis included patients treated with aspirin (100 mg) as a secondary prevention for ischemic stroke or transient ischemic attack. The bleeding events that occurred during the first year were collected, including gastrointestinal, skin, nasal cavity, gum, and urinary tract bleeding events. Then, univariate and multivariate logistic regression analyses were used to identify independent factors associated with bleeding events of aspirin. Results and discussion A total of 578 patients were enrolled in this study, and 58 patients developed bleeding during the first year of secondary prevention. Body weight and combination with selective serotonin reuptake inhibitors were found to be significant risk factors for overall bleeding (p = 0.025 and 0.012). Body weight below 60 kg was a risk factor for overall bleeding and gastrointestinal bleeding events. What is new and conclusion Patients weighing less than 60 kg were at increased risk of bleeding with 100 mg aspirin for secondary prevention of cerebral infarction transient ischemic attack.

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Section: Resultssupporting

confidence: 55%

“…And patients taking weight-based aspirin may have a reduced incidence of venous thromboembolism following primary total joint arthroplasty. 17 Similarly, in this retrospective study, we observed that body weight was related to bleeding adverse events of aspirin, and patients with low body weight seemed to be at a high risk of bleeding.…”

Section: Discussionmentioning

confidence: 51%

Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Wang

Zhu

et al. 2022

Clinical Pharmacy Therapeu

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“…In contrast to the studies discussed hitherto, Halbur et al, retrospectively compared the efficacy and safety of two ASA protocols in 2,284 standard-risk primary elective total joint arthroplasty patients 1823 . The first cohort received 81 mg bid, and the second cohort received ASA regimen bases on their weight, either 81 mg bid (if < 120 kg) or 325 mg bid (if ≥ 120 kg).…”

Section: - Is There a Difference Between Low Dose And Regular Dose As...mentioning

confidence: 99%

Recommendations from the ICM-VTE: General

2022

Journal of Bone and Joint Surgery

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“…84 In relation to VTE prophylaxis in patients weighing 120 kg, a higher dose of aspirin (320 mg twice daily) was shown to result in over 60% reduction in VTE incidence up to 6 months following surgery, when compared with 81 mg twice daily. 85 However, another smaller study showed no difference in 90-day VTE rates with either of these doses between BMI categories. 86…”

Section: Unfractionated Heparin and Aspirinmentioning

confidence: 95%

Obesity and the Risk of Venous Thromboembolism after Major Lower Limb Orthopaedic Surgery: A Literature Review

et al. 2022

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The risk of venous thromboembolism following total joint arthroplasty is significantly greater than those of other types of elective orthopaedic procedures. This risk is increased in obesity due to the associated prothrombotic physiological and hematological changes that predispose to embolic events. The prevalence of obesity is increasing in the aging population, which contributes to a further increase in the risk of postoperative thrombosis in the older patients. There is a lack of clear evidence regarding dosing information for thromboprophylaxis medications in patients with obesity. As a result, the currently available thromboprophylaxis guidelines do not provide specific recommendations for this group. Suboptimal dosing regimens for these medications can place these patients at a risk of bleeding or clotting complications postsurgery. Hence any increase in dosage may require intensive surveillance for the residual anticoagulant effects and careful balancing of risks and benefits on an individual basis. Our review discusses the basis for increased thrombotic risk in obesity, the evidence supporting dosage recommendations, and the implications of the current guidelines for pharmacological thromboprophylaxis in patients with obesity undergoing lower limb arthroplasty.

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Weight-Based Aspirin Dosing May Further Reduce the Incidence of Venous Thromboembolism Following Primary Total Joint Arthroplasty

Cited by 9 publications

References 45 publications

Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Recommendations from the ICM-VTE: General

Obesity and the Risk of Venous Thromboembolism after Major Lower Limb Orthopaedic Surgery: A Literature Review

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