Patients hospitalized with fractures typically receive an injectable blood thinner, low-molecular-weight heparin, to prevent life-threatening blood clots.
In a study from the University of Maryland and elsewhere, scientists found that inexpensive over-the-counter aspirin is just as effective.
The findings may lead surgeons to change their practice and administer aspirin to these patients.
Blood clots cause as many as 100,000 deaths in the U.S. each year, according to the U.S. Centers for Disease Control (CDC).
Patients who experience fractures that require surgery are at increased risk of developing blood clots in the lungs and limbs. Large clots in the lungs even can be life-threatening.
Current guidelines recommend prescribing low-molecular-weight heparin (enoxaparin) to prevent these clots, although smaller clinical trials in total joint replacement surgery suggested a potential benefit of aspirin as a less-expensive, widely available option.
In the study, researchers examined more than 12,000 patients at 21 trauma centers in the U.S. and Canada.
These patients with leg or arm fractures that necessitated surgery or pelvic fractures regardless of the treatment. Half were randomly assigned to receive 30 mg. of injectable low molecular-weight heparin twice daily.
The other half received 81 mg. of aspirin twice daily. Patients were followed for 90 days to measure health outcomes from the two treatments.
The team found that aspirin was “non-inferior,” or no worse than low molecular-weight heparin in preventing death from any cause—47 patients in the aspirin group died, compared with 45 patients in the heparin group.
The researchers also found no differences between the two groups in clots in the lungs (pulmonary embolisms).
The incidence of bleeding complications, infection, wound problems, and other adverse events from the treatments were also similar in both groups.
Of all the outcomes studied, the only potential difference noted was in blood clots in the legs, called deep vein thrombosis.
The study points to the importance of evaluating techniques used to prevent post-surgical complications, like blood clots and infections.
Given these important results, the team expects the guidelines for the prevention of blood clots to be revised to include the option of aspirin for patients with traumatic bone fractures.
If you care about bone health, please read studies about vitamin K deficiency linked to hip fractures in old people, and these vitamins could help reduce bone fracture risk.
For more information about wellness, please see recent studies that Krill oil could improve muscle health in older people, and Jarlsberg cheese could help prevent bone thinning disease.
The study was conducted by Robert V. O’Toole et al and published in the New England Journal of Medicine.
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