Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture

This multicenter, randomized noninferiority trial compared aspirin and low-molecular-weight heparin (LMWH) for thromboprophylaxis in 12,211 orthopedic trauma patients with extremity or pelvic fractures. Aspirin was noninferior to LMWH in preventing death from any cause at 90 days (0.78% vs. 0.73% mortality). Rates of pulmonary embolism (1.49% in both groups) and bleeding complications were similar, though deep-vein thrombosis was slightly more frequent in the aspirin group (2.51% vs. 1.71%). Aspirin’s oral administration and lower cost make it a viable alternative for thromboprophylaxis following orthopedic trauma.

This multicenter, randomized noninferiority trial compared aspirin and low-molecular-weight heparin (LMWH) for thromboprophylaxis in 12,211 orthopedic trauma patients with extremity or pelvic fractures. Aspirin was noninferior to LMWH in preventing death from any cause at 90 days (0.78% vs. 0.73% mortality). Rates of pulmonary embolism (1.49% in both groups) and bleeding complications were similar, though deep-vein thrombosis was slightly more frequent in the aspirin group (2.51% vs. 1.71%). Aspirin’s oral administration and lower cost make it a viable alternative for thromboprophylaxis following orthopedic trauma.