Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture
Primary resultResult — go to the resultDifference 0.05 percentage points 96.2% CI −0.27 to 0.38Authors' conclusion
In patients with extremity fractures that had been treated operatively or with any pelvic or acetabular fracture, thromboprophylaxis with aspirin was noninferior to low-molecular-weight heparin in preventing death and was associated with low incidences of deep-vein thrombosis and pulmonary embolism and low 90-day mortality.
Study context
- Population
- Patients ≥18 years with an operatively treated extremity fracture (hip to midfoot or shoulder to wrist) or any pelvic or acetabular fracture
- Participants
- 12,211 patients
- Comparison
- Aspirin vs Low-molecular-weight heparin
- Aspirinn = 6,101
- Low-molecular-weight heparinn = 6,110reference
- Primary endpoint
- Death from any cause
- Follow-up
- 90 days
Methodological detailspragmatic, multicentre, noninferiority
- Pragmatic
- Multicentre
- Noninferiority
Primary result
As reported in the abstract
Difference
0.05 percentage points
96.2% CI −0.27 to 0.38
P < 0.001
Events by treatment group
Aspirin vs Low-molecular-weight heparin
difference 0.05 percentage points (96.2% CI −0.27 to 0.38); P < 0.001
Non-inferiority margin 0.75 as printed, not drawn
Secondary outcomes
| Outcome | Aspirin | Low-molecular-weight heparin | Difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| DVT | 2.51% | 1.71% | 0.80 (0.28–1.31) | |
| −1012Difference, percentage points (linear scale) |
PE
PE
- Similar in the two groups
Safety
Bleeding complications and other serious adverse events
- Similar in the two groups
Original publication
Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture. N Engl J Med. Published 19 January 2023. doi:10.
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