Adult Reconstruction Unit, Division of Orthopedics, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Hospital for Joint Diseases, NYU Langone Orthopedic Hospital, New York, USA.
Arch Orthop Trauma Surg. 2020 Dec;140(12):2101-2107. doi: 10.1007/s00402-020-03629-7. Epub 2020 Oct 11.
Acetylsalicylic acid (aspirin) is a commonly prescribed medication, especially in the age group of individuals who undergo elective total hip arthroplasty (THA). Preoperative discontinuation of aspirin is believed to reduce intraoperative bleeding and other complications, but it may increase the risk of perioperative cardiovascular events. In this study we have sought to evaluate the safety of continuous aspirin treatment in patients undergoing elective THA.
This is a retrospective analysis of a consecutive cohort who underwent elective THA in a tertiary medical center between 2011 and 2018. The cohort was divided into two groups-one that received continuous preoperative aspirin treatment and one that did not. Blood loss, peri- and postoperative complications, readmissions, and short- and long-term mortality were compared between groups.
Out of 757 consecutive patients (293 males, 464 females) who underwent elective primary THA, 552 were in the "non-aspirin" group and 205 were in the "aspirin" group and were not treated preoperative with other medication affecting hemostasis. Perioperative continuation of aspirin treatment did not significantly increase perioperative bleeding, as indicated by changes in hemoglobin levels (P = 0.72). There were no significant differences in short- and long-term mortality (P = 0.47 and P = 0.4, respectively) or other perioperative complications, such as readmission (P = 0.78), deep or superficial infection (P = 1 and P = 0.47, respectively), and cardiovascular events (none in both groups).
Peri-operative continuation of aspirin treatment in patients undergoing elective primary THA did not increase perioperative complications or mortality compared to the non-aspirin-treated patients. The protective effects of aspirin from postoperative thrombotic and cardiovascular events are well documented. The current findings dispute the need to preoperatively withhold aspirin treatment in patients undergoing elective primary THA.
乙酰水杨酸（阿司匹林）是一种常用的处方药物，尤其是在接受择期全髋关节置换术（THA）的人群中。术前停用阿司匹林被认为可以减少术中出血和其他并发症，但可能会增加围手术期心血管事件的风险。在这项研究中，我们旨在评估接受择期 THA 的患者继续使用阿司匹林治疗的安全性。
这是一项对 2011 年至 2018 年在三级医疗中心接受择期 THA 的连续队列的回顾性分析。该队列分为两组，一组接受术前持续阿司匹林治疗，另一组未接受。比较两组之间的失血量、围手术期并发症、再入院率以及短期和长期死亡率。
在 757 例连续接受择期初次 THA 的患者（293 例男性，464 例女性）中，552 例患者在“非阿司匹林”组，205 例患者在“阿司匹林”组，术前未用其他影响止血的药物治疗。围手术期继续使用阿司匹林治疗并未显著增加围手术期出血，如血红蛋白水平变化所示（P=0.72）。两组的短期和长期死亡率均无显著差异（P=0.47 和 P=0.4，分别）或其他围手术期并发症，如再入院（P=0.78）、深部或浅部感染（P=1 和 P=0.47，分别）和心血管事件（两组均无）。
与未接受阿司匹林治疗的患者相比，接受择期初次 THA 的患者围手术期继续使用阿司匹林治疗并未增加围手术期并发症或死亡率。阿司匹林预防术后血栓和心血管事件的保护作用已有充分的文献记载。目前的研究结果质疑在接受择期初次 THA 的患者术前是否需要停用阿司匹林。
