Comparing the usage of aspirin and heparin in preventing blood clot in patient who had experienced fracture
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on February 2nd, 2023
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Patients who had suffered an orthopedic trauma experienced an increased risk of venous thromboembolism. Low-molecular-weight heparin is recommended as prophylaxis to prevent blood clot for patients who have had a fracture. A recent study found that aspirin can also be used as an effective thromboprophylaxis with less adverse effects. But there has not been any direct comparison between heparin and aspirin in preventing blood clot. The Major Extremity Trauma Research Consortium (METRC) had recently published their findings on the effectiveness of aspirin versus heparin.
The clinical trial enrolled 12,211 patients who had recently suffered a fracture in their hip, acetabulum, upper or lower extremities. Half of these patients were randomly assigned to receive a 30 mg subcutaneous injection of enoxaparin, twice a day. The other half was assigned to take 81 mg of aspirin, twice a day. The length of treatment was administered depending on each patient’s case, and their health status was monitored for 90 days after randomization. The mortality rate was equal between the aspirin and heparin group, 0.78% versus 0.73% respectively. However, there was not a control group, so we cannot be certain if the intervention were effective at preventing death. However, aspirin was not effective at preventing deep vein thrombosis (rate = 2.51%) as low-molecular-weight heparin (rate = 1.71%). Besides, there was little difference in the risk of pulmonary embolism and other adverse events (bleeding, wound complication, and infection). It is important to note that aspirin can be administered orally; whereas, heparin must be injected subcutaneously. Thus, the usage of aspirin is easier and has a higher rate of treatment adherence. In addition, aspirin can be used in the out-patient setting after the patient is discharged from the hospital after initial treatment with heparin.
The clinical trial enrolled 12,211 patients who had recently suffered a fracture in their hip, acetabulum, upper or lower extremities. Half of these patients were randomly assigned to receive a 30 mg subcutaneous injection of enoxaparin, twice a day. The other half was assigned to take 81 mg of aspirin, twice a day. The length of treatment was administered depending on each patient’s case, and their health status was monitored for 90 days after randomization. The mortality rate was equal between the aspirin and heparin group, 0.78% versus 0.73% respectively. However, there was not a control group, so we cannot be certain if the intervention were effective at preventing death. However, aspirin was not effective at preventing deep vein thrombosis (rate = 2.51%) as low-molecular-weight heparin (rate = 1.71%). Besides, there was little difference in the risk of pulmonary embolism and other adverse events (bleeding, wound complication, and infection). It is important to note that aspirin can be administered orally; whereas, heparin must be injected subcutaneously. Thus, the usage of aspirin is easier and has a higher rate of treatment adherence. In addition, aspirin can be used in the out-patient setting after the patient is discharged from the hospital after initial treatment with heparin.