Biomaterial Database

Aspirin and compression devices versus low-molecular-weight heparin and PCD for VTE prophylaxis in orthopedic oncology patients. 2010

Anay R Patel, and Martha K Crist, and Jason Nemitz, and Joel L Mayerson

Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

BACKGROUND Deep venous thrombosis (DVT) and pulmonary embolism (PE) are possible sources of morbidity and mortality in patients with musculoskeletal neoplasms (MSN). OBJECTIVE To compare the efficacy of aspirin (ASA) and pneumatic compression devices (PCD) to low-molecular-weight heparin (LMWH) and PCD in patients undergoing orthopedic procedures for MSN of the pelvis or lower extremity. METHODS Of 348 patients who met the study criteria, 195 were treated with ASA/PCD and 153 with LMWH/PCD. There were 18 DVT including 8 in ASA/PCD group and 10 in LMWH/PCD group. There were four PEs, all in the LMWH/PCD group. RESULTS We found no significant difference in DVT rate between ASA/PCD and LMWH/PCD when used for prophylaxis against thromboembolic complications. Our analysis shows that procedures of the thigh, soft tissue resections, and malignant disease were more often managed with ASA/PCD while joint arthroplasty, procedures of the hip/pelvis, and metastatic disease were more often managed with LMWH/PCD. CONCLUSIONS DVT prophylaxis in orthopedic oncology remains a complex topic in which physicians must balance the risks of thromboembolic disease against the risks of post-operative complications.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D001859	Bone Neoplasms	Tumors or cancer located in bone tissue or specific BONES.	Bone Cancer,Cancer of Bone,Cancer of the Bone,Neoplasms, Bone,Bone Neoplasm,Neoplasm, Bone
D005260	Female		Females
D006493	Heparin	A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.	Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006495	Heparin, Low-Molecular-Weight	Heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism.	LMWH,Low-Molecular-Weight Heparin,Low Molecular Weight Heparin,Heparin, Low Molecular Weight
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D001241	Aspirin	The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)	Acetylsalicylic Acid,2-(Acetyloxy)benzoic Acid,Acetysal,Acylpyrin,Aloxiprimum,Colfarit,Dispril,Easprin,Ecotrin,Endosprin,Magnecyl,Micristin,Polopirin,Polopiryna,Solprin,Solupsan,Zorprin,Acid, Acetylsalicylic