PE - Pulmonary Thromboembolism Clinical Trial
Official title:
Outcomes Study to Determine the Incidence of Symptomatic DVT/PE in Patients Receiving Aspirin With Mechanical Compression Devices Versus Aspirin Alone Following Knee and Hip Arthroplasty
The Purpose is to compare the safety and efficacy of the use of aspirin(ASA) with medical compression devices versus aspirin alone for venous thromboprophylaxis following knee and hip arthroplasty.
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary
embolism (PE), is the most common complication occurring in association with knee and hip
arthroplasty procedures due to an activation of the clotting cascade during bone and
intramedullary canal preparation.DVT rates ranging from 4% to 15 % and PE rates ranging from
0.83% to 3% have been reported, with fatal PE rates reduced with the use of postoperative
anticoagulation. The high risk of thromboembolic disease has led to recommendations that
pharmacoprophylaxis be considered routinely. • The combination of short duration outpatient
anticoagulation, early mobilization, and mechanical prophylaxis has recently been studied at
our institution (Barnes-Jewish Hospital) and has been effective in prophylaxis against VTE.
Current American College of Chest Physician (ACCP) guidelines recommend that a longer
duration of outpatient anticoagulation following TKA / THA surgery may further reduce the
risk of VTE.
Shorter patient hospitalizations and earlier discharge require an outpatient VTE prophylaxis
regimen that is simple, effective, easy to monitor, predictable, and has a high patient
compliance. Currently, "routine" risk patients receive a combination of ASA 325mg BID (twice
daily) for a period of 6 weeks, and portable, mobile pneumatic compression devices (MCDs)
for a period of 10 days post- surgery.The study is testing to see whether the use of ASA
alone can be equally effective versus the use of ASA with MCDs in "routine" risk patients
following total joint arthroplasty.Patients are enrolled fpr 6 months following surgery, and
data collection occurs pre-surgery, 14 days after surgery, at the 4-8 wk visit and finally,
at 6 months post surgery. We are evaluating the stated outcomes over this 6 month period.
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