摘要
Our objective is to evaluate different pharmacologic strategies for VTE （venous thromboembolism） prophylaxis following orthopedic surgery at a tertiary academic medical center. This was a retrospective, observational study assessing the efficacy and safety of different strategies for VTE prophylaxis in elective total knee arthroplasty and total hip arthroplasty surgery patients. We evaluated warfarin at two different INR （international normalized ratio） goal ranges （1.5-2.5 and 1.8-2.3） and aspirin 325 mg once or twice daily. The main efficacy outcome was a composite of symptomatic deep vein thrombosis or pulmonary embolism. The main safety outcome was incidence of major or minor bleeding. From January 2010 to June 2010, there were 190 patients in the warfarin group with INR range 1.5-2.5, 214 patients in the warfarin group with INR range 1.8-2.3, and 48 patients in the aspirin group. Of the three strategies, two primary events occurred in each of the warfarin groups （1.6% vs. 1.4%; P = 0.31）. There were no primary events in the aspirin group. Rates of major or minor bleeding were 4.2% in warfarin group INR 1.5-2.5 and 4.7% in warfarin group 1NR 1.8-2.3 （P = 0.19）, and 2.1% in the aspirin arm （P = 0.29）. There were no differences in the incidence of VTE in any of the treatment arms.
