Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, Korea.
J Korean Med Sci. 2011 Dec;26(12):1625-9. doi: 10.3346/jkms.2011.26.12.1625. Epub 2011 Nov 29.
Since the late 1980s, low dose aspirin has been used to prevent stroke and ischemic heart disease. However, prophylactic effect of antiplatelets against venous thromboembolism (VTE), in patients who undergo hip fracture surgery (HFS) is controversial. Our purpose was to determine the incidence of symptomatic VTE after HFS and to evaluate whether antiplatelets reduce the development of symptomatic VTE following HFS. We retrospectively reviewed 858 HFS in 824 consecutive patients which were performed from May 2003 to April 2010 at an East Asian institute. We compared the incidence of symptomatic VTE in antiplatelet users and non-users using multivariate logistic regression analyses. Overall incidences of symptomatic pulmonary embolism including fatal pulmonary embolism, and symptomatic deep vein thrombosis in this study were 2.4% (21/858), and 3.5% (30/858), respectively. The incidence of symptomatic VTE was 4.8% (12/250) in antiplatelet users and 4.3% (26/608) in non-users (P = 0.718). It is suggested that antiplatelet agents are not effective in prevention of symptomatic VTE after HFS.
自 20 世纪 80 年代末以来,小剂量阿司匹林已被用于预防中风和缺血性心脏病。然而,在接受髋关节骨折手术(HFS)的患者中,抗血小板药物预防静脉血栓栓塞症(VTE)的预防性效果存在争议。我们的目的是确定 HFS 后症状性 VTE 的发生率,并评估抗血小板药物是否减少 HFS 后症状性 VTE 的发生。我们回顾性分析了 2003 年 5 月至 2010 年 4 月在东亚研究所进行的 824 例连续患者的 858 例 HFS。我们使用多变量逻辑回归分析比较了抗血小板药物使用者和非使用者中症状性 VTE 的发生率。本研究中,症状性肺栓塞(包括致命性肺栓塞)和症状性深静脉血栓形成的总发生率分别为 2.4%(21/858)和 3.5%(30/858)。抗血小板药物使用者中症状性 VTE 的发生率为 4.8%(12/250),而非使用者中为 4.3%(26/608)(P=0.718)。提示抗血小板药物不能有效预防 HFS 后症状性 VTE。