医学
单室膝关节置换术
入射(几何)
肺栓塞
阿司匹林
关节置换术
深静脉
置信区间
血栓形成
外科
骨关节炎
内科学
光学
物理
病理
替代医学
作者
Luke Ogonda,Janet Hill,E. Doran,Janice Dennison,Mark Stevenson,David Beverland
出处
期刊:The bone & joint journal
[British Editorial Society of Bone and Joint Surgery]
日期:2016-03-01
卷期号:98-B (3): 341-348
被引量:83
标识
DOI:10.1302/0301-620x.98b3.36511
摘要
The aim of this study was to present data on 11 459 patients who underwent total hip (THA), total knee (TKA) or unicompartmental knee arthroplasty (UKA) between November 2002 and April 2014 with aspirin as the primary agent for pharmacological thromboprophylaxis.We analysed the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) then compared the 90-day all-cause mortality with the corresponding data in the National Joint Registry for England and Wales (NJR).The incidence of PE was 0.6% after THA, 1.47% after TKA and 1.2% after UKA. The 90-day mortality was 0.39% after THA and 0.44% after TKA. No deaths occurred after UKA. The main causes of death were ischaemic heart disease and respiratory failure. PE was responsible for only 18% of deaths. There was a decline in 90-day mortality, from 0.64% between 2002 and 2007, to 0.21% between 2008 and 2013 after THA, and from 0.47% to 0.39% after TKA for the corresponding period. The standardised mortality ratio (SMR) declined from 86.5 (confidence interval (CI) 63.0 to 137.7) to 39.7 (CI 31.2 to 54.3) p = 0.024. The incidence of proximal DVT was 0.3%.With individualised risk assessment and as part of a multimodal approach, Aspirin is safe to use as the main thromboprophylactic agent in primary arthroplasty. It is not associated with an increased incidence of symptomatic DVT, PE or death.
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