Perioperative medicine & outcomes

Effect of Aspirin vs Enoxaparin on 90-Day Mortality in Patients Undergoing Hip or Knee Arthroplasty: A Secondary Analysis of the CRISTAL Cluster Randomized Trial

JAMA Netw OpenPublished Secondary analysis of the CRISTAL randomised trial

Primary result · Mortality within 90 daysResult — go to the resultEstimated difference 0.04% 95% CI −0.05%-0.42%

Authors' conclusion

In this secondary analysis of a cluster randomized trial comparing aspirin with enoxaparin following hip or knee arthroplasty, there was no significant between-group difference in mortality within 90 days when either drug was used for VTE prophylaxis.

Study context

Population
Adults (≥18 years) undergoing any hip or knee arthroplasty at 31 Australian hospitals, 2019–2020
Participants
23,458 adults · 31 hospitals
Comparison
Aspirin vs enoxaparin for venous thromboembolism (VTE) prophylaxis
  • Aspirinn = 14,156
  • Enoxaparinn = 9,302reference
Primary endpoint
Mortality
Follow-up
90 days
Methodological detailsplanned secondary analysis, cluster randomized, crossover, registry-nested, multicentre
  • Planned secondary analysis
  • Cluster randomized
  • Crossover
  • Registry-nested
  • Multicentre

Primary result

Mortality within 90 days

Estimated difference

0.04%

95% CI −0.05%-0.42%

By group

Aspirin vs Enoxaparin
estimated difference 0.04% (95% CI −0.05%-0.42%)

As reported in the abstract

Further findings

OutcomeAspirinEnoxaparinEstimated difference (95% CI)
Mortality within 90 days, nonfracture diagnosis (subgroup, n = 21 148)0.49%0.41%0.05% (−0.67% to 0.76%)

Original publication

Effect of Aspirin vs Enoxaparin on 90-Day Mortality in Patients Undergoing Hip or Knee Arthroplasty: A Secondary Analysis of the CRISTAL Cluster Randomized Trial. JAMA Netw Open. Published 1 June 2023. doi:10.1001/jamanetworkopen.2023.17838

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