ArticleOrthopedic reviews2026
Meta-analysis of Randomized Trials in Emergency and Acute Orthopedic Trauma Comparing Aspirin and Low-Molecular-Weight Heparin for Thromboprophylaxis.
Article in Orthopedic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Venous thromboembolism remains an important complication after acute orthopedic trauma. Low molecular weight heparin has historically been the conventional pharmacologic standard for thromboprophylaxis, while aspirin has gained increasing clinical interest as a practical alternative. This systematic review and meta-analysis evaluated randomized controlled trial evidence comparing aspirin with low molecular weight heparin after acute orthopedic trauma. Methods: PubMed, Scopus, and Web of Science were systematically searched from database inception through March 21, 2026. Randomized controlled trials comparing aspirin with low molecular weight heparin in adults with acute orthopedic trauma requiring thromboprophylaxis were included. Primary outcomes were all cause mortality, bleeding complications, and infection related complications. Quantitative synthesis was performed where appropriate using pooled risk ratios with 95% confidence intervals under a random effects model. Venous thromboembolic outcomes were synthesized qualitatively because of heterogeneous endpoint definitions. Results: Four publications representing two independent randomized orthopedic trauma trial programs involving 12,540 participants were included. Meta analysis showed no statistically significant differences between aspirin and low molecular weight heparin for all cause mortality (risk ratio 1.02, 95% confidence interval 0.69 to 1.53), bleeding complications (risk ratio 0.96, 95% confidence interval 0.88 to 1.05), or infection related complications (risk ratio 1.05, 95% confidence interval 0.80 to 1.37). No statistical heterogeneity was observed across pooled outcomes. Conclusion: Aspirin did not demonstrate statistically significant differences from low molecular weight heparin in mortality or major safety outcomes within the currently available randomized orthopedic trauma evidence. However, comparative venous thromboembolic efficacy remains uncertain because thromboembolic outcomes could not be validly pooled. Further trauma specific randomized studies with standardized outcome reporting are needed.
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