To prevent life-threatening clots from forming, patients hospitalized with a fracture are prescribed an injectable blood thinner. A study reveals that aspirin is just as effective.
- Aspirin is the most produced medicine in the world. About 40,000 tons are produced per year.
- If aspirin is available over the counter, it is still a medicine: it should not be taken lightly. Thus, its use without medical advice can only be occasional.
- There are several contraindications to taking aspirin: in case of stomach or duodenal ulcer, risk of bleeding, severe hepatic insufficiency, severe renal insufficiency or in case of allergy to molecule. Pregnant women should also avoid it from the 6th month of pregnancy.
Immobilization due to a fracture promotes, among other things, the formation of blood clots. To avoid this complication, patients receive anticoagulant injections during treatment. A clinical trial with more than 12,000 patients operated on for a bone fracture sought to evaluate the different techniques to combat this risk. The researchers found that aspirin was as effective as standard treatment.
Clots: aspirin as effective as anticoagulants
The participants of the study, published in New England Journal of Medicine, had had a leg or arm fracture that required surgery or a pelvic fracture that immobilized them. A first half received an injectable anticoagulant (heparin) twice a day. The other took 81 mg of aspirin twice a day. Patients were followed for 90 days.
The researchers found that aspirin was neither “worse” nor “worse” than the anticoagulant in preventing patient death (47 deaths for the aspirin group versus 45 for the heparin group). Also, there was no difference in the risk of clots in the lungs (pulmonary embolism). The incidence of bleeding complications, infections and other adverse events was also similar in the two groups.
“Of all the outcomes studied, the only potential difference noted was for blood clots in the legs, called deep vein thrombosis. This condition was relatively rare in both groups, occurring in 2.5% of patients in the group aspirin and in 1.7% of patients in the heparin group”write the authors.
“This relatively small difference was due to clots lower in the leg, which are considered to be of less clinical significance and often do not require treatment”says co-principal investigator Dr. Deborah Stein, a professor of surgery at the University of Maryland School of Medicine and director of adult critical care services at the facility’s trauma center.
Fractures: easier post-operative treatment
For the American scientists, their discovery opens the door to a simpler and less expensive post-operative treatment of fractures.
“Many fracture patients are likely to strongly prefer taking a daily aspirin to receiving injections after we found that both give them similar results for preventing the most serious consequences of blood clots”says the study’s lead researcher, Dr. Robert V. O’Toole, chief of orthopedics at the University of Maryland School of Medicine’s Trauma Center.
“We expect the results of this large trial to have a significant impact on clinical practice that may even change the standard of care”he adds.
