drcadera

💊Aspirin for Thromboprophylaxis After Fracture: The PREVENT CLOT Trial Published in the @NEJM Venous thromboembolism is one of the most dangerous complications in trauma cases. Low molecular weight heparin is regularly used for prophylaxis. But could aspirin be just as good? 🏗️METHODS This randomized, non-inferiority trial included 21 centers in the US 🇺🇸 and Canada 🇨🇦 randomized 12,211 patients with an extremity, pelvic, or acetabulum fracture to receive: 1⃣ Aspirin (81mg twice daily) (n=6,101) 2⃣ Low-Molecular-Weight Heparin (30mg twice daily enoxaparin) (n=6,110) The primary outcome of interest was all-cause mortality at 90 days. Secondary efficacy outcomes included: cause-specific death, non-fatal pulmonary embolism, and deep-vein thrombosis. Secondary safety outcomes included: bleeding events, wound complications, and surgical site infection. 🔎 RESULTS All-Cause Mortality Aspirin was found to be non-inferior to low-molecular-weight heparin (p<0.001)! Secondary Efficacy Outcomes Similar rates of cause-specific death (relation to pulmonary embolism) and pulmonary embolism were observed between the two groups. However, the rate of deep vein thrombosis - in particular distal deep vein thrombosis - was higher in the aspirin group! Secondary Safety Outcomes Similar rates of bleeding complications, wound complications, and infection were observed between the two groups. ✅ INTERPRETATION Aspirin was non-inferior to low-molecular-weight heparin for the prevention of all-cause mortality! It has a similar safety profile too -- aspirin could be a safe, low-cost alternative for thromboprophylaxis after a fracture!