Comparação de ácido acetilsalicílico e anticoagulante oral direto como tromboprofilaxia após artroplastia total do joelho: Um estudo retrospectivo

Resumo

Objetivo O tromboembolismo venoso (TEV) ainda é um grande desafio após grandes cirurgias ortopédicas, incluindo a artroplastia total do joelho (ATJ). O objetivo deste estudo foi estimar o risco de TEV com profilaxia farmacológica apenas com ácido acetilsalicílico ou anticoagulante oral direto (AOD) após a cirurgia primária de ATJ.

Métodos O estudo incluiu 476 pacientes submetidos a ATJ primária de 2016 a 2020. Todos os pacientes receberam tromboprofilaxia com AOD (grupo AOD) (n = 267) ou ácido acetilsalicílico (AAS) (grupo AAS) (n = 209). Os desfechos clínicos foram avaliados e comparados entre aqueles que receberam AOD e AAS. O desfecho primário foi a incidência de TEV. O desfecho secundário foi a ocorrência de complicações da ferida.

Resultado O AAS e o AOD foram comparáveis na prevenção de TEV em pacientes submetidos a ATJ primária. A incidência de trombose venosa profunda foi semelhante nos grupos AAS (10%) e AOD (10,1%, p = 0,98), sem nenhum caso de embolia pulmonar em ambos os grupos. Não houve diferença significativa entre os grupos AAS (1,4%) e AOD (1,5%) em relação às complicações da ferida (p = 0,95).

Conclusão A tromboprofilaxia pós-operatória apenas com AAS não foi associada a um maior risco de TEV pós-operatório em comparação à AOD após ATJ. Considerando a ampla disponibilidade e custo-benefício, o AAS pode ser uma alternativa promissora ao AOD para a profilaxia de TEV.

Palavras-chave

anticoagulantes - artroplastia do joelho - tromboembolia venosa

Contribuições dos Autores

Todos os autores contribuíram para a concepção e delineamento do estudo. A preparação do material, a coleta e a análise dos dados foram realizadas por Maria Anastasia e Leonard Christianto. Todos os autores leram e aprovaram o manuscrito final.

Trabalho desenvolvido no Departamento de Cirurgia Ortopédica, St. Carolus Hospital, Jakarta, Indonésia.

Publication History

Received: 04 March 2023

Accepted: 21 July 2023

Article published online:
21 December 2024

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