PMID- 34052098 OWN - NLM STAT- MEDLINE DCOM- 20211025 LR - 20211025 IS - 1532-8406 (Electronic) IS - 0883-5403 (Linking) VI - 36 IP - 9 DP - 2021 Sep TI - Thirty Days of Aspirin for Venous Thromboembolism Prophylaxis Is Adequate Following Total Knee Arthroplasty, Regardless of the Dose Used. PG - 3300-3304 LID - S0883-5403(21)00416-2 [pii] LID - 10.1016/j.arth.2021.05.002 [doi] AB - BACKGROUND: The optimal length of aspirin prophylaxis to minimize venous thromboembolism (VTE) following total knee arthroplasty (TKA) remains unknown. This study aimed to determine the timing of VTE after TKA in patients who received low and high dose aspirin, and determine if 30 days of prophylaxis remains adequate. METHODS: We retrospectively reviewed records of 9208 patients undergoing primary TKA between 2010 and 2020 who received either low (81 mg twice daily, n = 4413) or high (325 mg twice daily, n = 4795) dose aspirin for VTE prophylaxis. Symptomatic VTEs occurring within 90 days of surgery were identified from medical records and phone call logs. Major bleeding events (MBE) within the first 30 days were also documented. Time to event was recorded. RESULTS: Overall, 88 patients (1.0%) developed symptomatic VTE, with no significant differences in incidence between the low (n = 40, 0.9%) and high (n = 48, 1.0%) dose groups (P = .669). The median time to VTE was 8 days (interquartile range [IQR] 2-15.5), median time to deep vein thrombosis was 12 days (IQR 5-18), and median time to pulmonary embolism was 5 days (IQR 1.5-15). There was a similar distribution in time to VTE in both the low and high dose groups. Aside from a single DVT occurring at day 44, all VTE occurred within 30 days of surgery. During the prophylactic time period, 41 patients (0.4%) developed MBE, which tended to occur more frequently (0.6% vs 0.3%, P = .018) and earlier in the high dose group. CONCLUSION: Based on the findings, a 30-day low or high dose aspirin regimen remains optimal for prevention of VTE without increasing MBE in TKA patients. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Shohat, Noam AU - Shohat N AD - Department of Orthopedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA; Department of Orthopedics, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. FAU - Ludwick, Leanne AU - Ludwick L AD - Department of Orthopedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Goel, Rahul AU - Goel R AD - Department of Orthopedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Ledesma, Jonathan AU - Ledesma J AD - Department of Orthopedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Streicher, Sydney AU - Streicher S AD - Department of Orthopedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA. FAU - Parvizi, Javad AU - Parvizi J AD - Department of Orthopedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA. LA - eng PT - Journal Article DEP - 20210508 PL - United States TA - J Arthroplasty JT - The Journal of arthroplasty JID - 8703515 RN - 0 (Anticoagulants) RN - R16CO5Y76E (Aspirin) SB - IM MH - Anticoagulants MH - *Arthroplasty, Replacement, Hip MH - *Arthroplasty, Replacement, Knee/adverse effects MH - Aspirin MH - Humans MH - Retrospective Studies MH - *Venous Thromboembolism/epidemiology/etiology/prevention & control OTO - NOTNLM OT - aspirin OT - complication OT - prophylaxis OT - pulmonary embolism OT - timing OT - total knee arthroplasty EDAT- 2021/05/31 06:00 MHDA- 2021/10/26 06:00 CRDT- 2021/05/30 20:37 PHST- 2021/01/29 00:00 [received] PHST- 2021/04/28 00:00 [revised] PHST- 2021/05/03 00:00 [accepted] PHST- 2021/05/31 06:00 [pubmed] PHST- 2021/10/26 06:00 [medline] PHST- 2021/05/30 20:37 [entrez] AID - S0883-5403(21)00416-2 [pii] AID - 10.1016/j.arth.2021.05.002 [doi] PST - ppublish SO - J Arthroplasty. 2021 Sep;36(9):3300-3304. doi: 10.1016/j.arth.2021.05.002. Epub 2021 May 8.