Abstract

LOPREITE, Fernando A.; DAINOTTO, Tamara; GAGGIOTTI, Stéfano  and  DEL SEL, Hernán. Estudio retrospectivo comparativo entre aspirina y dabigatrán en la incidencia de eventos tromboembólicos en pacientes con artroplastia de cadera y rodilla. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2021, vol.86, n.4, pp.446-454. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2021.86.4.1303.

Objective: To analyze the incidence of out-of-hospital thromboembolic events after a primary total knee or hip replacement in the first 90 postoperative days, using acetylsalicylic acid or dabigatran as thromboprophylaxis. As a secondary objective, to evaluate the cost of antiplatelet therapy compared to anticoagulants. Materials and Methods: A retrospective observational study was carried out in the postoperative period of primary total hip and knee replacement on the incidence of out-of-hospital thromboembolic events during the first 90 postoperative days in two groups of patients. Acetylsalicylic acid (325 mg per day) or dabigatran (150 to 220 mg per day) were used as thromboprophylaxis for 35 days. Results: The series consisted of 224 patients aged 68.5 years (38-95 years), 44.2% male. 51.3% corresponded to total hip replacement. 64.3% continued thromboprophylaxis with dabigatran and 35.7% with aspirin. The total incidence of thromboembolic events was 1.3%. In the patients who received dabigatran it was 1.4% and in those who received aspirin, 1.3% (p = 0.9). The cost of thromboprophylaxis with aspirin 325 mg was US $ 3.6 while with dabigatran it was US $ 130 or $ 175, according to its presentation, 75 and 110 mg. Conclusion: Aspirin as thromboprophylaxis after total hip or knee replacement in individuals at low risk of thromboembolic events has shown similar clinical outcomes as dabigatran, and a multimodal protocol based on the use of aspirin can be recommended. This improves patient adherence to antithrombotic therapy, due to the low cost of aspirin prophylaxis.

Keywords : Aspirin; acetylsalicylic acid; dabigatran; thromboprophylaxis; thromboembolic event; hip arthroplasty; knee arthroplasty.

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