Evidence map›Paper›PMID 31660024›Full record

ArticleJournal of orthopaedics

Should we use dabigatran or aspirin thromboprophylaxis in total hip and knee arthroplasty? A natural experiment.

Stephen McHale, Mark Williams, Canice O'Mahony, Michael Hockings

Abstract read
In one paragraph

Article in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Stephen McHaleDepartment of Trauma and Orthopaedics, Torbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, TQ2 7AA, UK.
Mark WilliamsDepartment of Trauma and Orthopaedics, Torbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, TQ2 7AA, UK.
Canice O'MahonyDepartment of Trauma and Orthopaedics, Torbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, TQ2 7AA, UK.
Michael HockingsDepartment of Trauma and Orthopaedics, Torbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, TQ2 7AA, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite long clinical experience some authorities recommend against the use of aspirin for perioperative VTE prophylaxis and favour alternatives such as dabigatran. A change from Dabigatran to an Aspirin based protocol in a British district general hospital created the conditions of a natural experiment.

methodsWe conducted a single centre, retrospective study of 6-months using a dabigatran based protocol (THA n = 191, TKA n = 155) and 6-months using and aspirin based protocol (THA n = 165, TKA n = 136). Outcomes addressed include: VTE used, VTE events within 90-days, 30-day return to theatre (RTT) rates, and 90-day mortality.

resultsPre-intervention, the dabigatran prescription rate was 73% (n = 139) and 78% (n = 123) with aspirin prescription post-intervention in 67% (n = 110) and 70% (n = 90) for THA and TKA respectively. We found a similar VTE rate when comparing dabigatran and aspirin groups for THA (2.2% vs. 0%, p = 0.17) and TKA (0.64% vs. 0%, p = 0.32). Similarly, no difference in the RTT rate was seen for THA (0.7% vs.2.7%, p = 0.23) or TKA (1.6% vs. 3.2%, p = 0.38).

conclusionNo significant differences in safety were found comparing aspirin to dabigatran for VTE prophylaxis for lower limb arthroplasty which, has not been previously reported and represents significant cost saving implications.

Indexed as

ArthroplastyAspirinDabigatranHipKneeThromboprophylaxis

Identifiers

PMID31660024
PMCPMC6806636

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.