image: Javad Parvizi, M.D., director of Research at the Rothman Institute at Jefferson and colleagues in recent research recognized at the American Association of Hip and Knee Surgeons annual meeting showed that aspirin was just as effective as warfarin in preventing clots following joint replacement surgery. view more
Credit: Thomas Jefferson University Hospital
(PHILADELPHIA) – If you've had joint replacement surgery, it's likely you've been given warfarin, a common blood thinner and clot-preventer, prior to surgery. While effective, research from the Rothman Institute at Jefferson has shown aspirin to be just as effective in preventing clots, specifically pulmonary emboli, life-threatening blood clots that can develop in the arteries of the lungs following joint replacement surgery. Their research was recognized as one of the best poster presentations at the recent American Association of Hip and Knee Surgeons (AAHKS) meeting in Dallas.
"While warfarin is successful in the prophylactic prevention of clots it can also lead to increased bleeding, infections and hospital readmissions," says Javad Parvizi, MD, director of Research at the Rothman Institute and lead author on the study.
The study compared the outcomes of 26,415 patients who underwent joint replacement surgery at the Rothman Institute between 2000 and 2011; 1,824 of whom received aspirin and 24,567 of whom received warfarin prophylactically prior to surgery. Both groups were monitored for up to 90 days postoperatively.
Their results showed the overall rate of pulmonary embolism to be significantly lower in the patients who received aspirin (0.2 percent or four in 1,824) versus those who received warfarin (1.0 percent or 92 in 9028). In addition, hematoma, a leakage of blood external to the blood vessel or a leakage of fluid known as a seroma, wound problems, acute infection and 90-day mortality rates were also lower in the aspirin group.
"Our study shows that aspirin is a viable alternative to warfarin in healthy patients, with better results in preventing clots, and a lower rate of bleeding and wound complications," says Parvizi. "It will allow all us to move away from expensive, inconvenient, and dangerous drugs in the prevention of thromboembolism after joint replacement." Rothman Institute at Jefferson surgeons have begun to replace warfarin with aspirin for pre-surgical prophylactic clot prevention.
Thomas Jefferson University Hospitals
Thomas Jefferson University Hospitals (TJUH) are dedicated to excellence in patient care, patient safety and the quality of the healthcare experience. Consistently ranked by U.S. News & World Report among the nation's top hospitals, Thomas Jefferson University Hospital, established in 1825, has over 900 licensed acute care beds with major programs in a wide range of clinical specialties. TJUH is one of the few hospitals in the U.S. that is both a Level 1 Trauma Center and a federally-designated regional spinal cord injury center. TJUH patient care facilities include Jefferson Hospital for Neuroscience, the region's only dedicated hospital for neuroscience, Methodist Hospital in South Philadelphia, and additional patient care facilities throughout Pennsylvania and New Jersey. TJUH partners with its education affiliate, Thomas Jefferson University.