Aspirin Versus Low-Molecular-Weight Heparin After Total Hip Arthroplasty
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Abstract
LettersOctober 1, 2013Aspirin Versus Low-Molecular-Weight Heparin After Total Hip ArthroplastySerena Granziera, MD and Alexander T. Cohen, MD, MBBS, MScSerena Granziera, MDFrom University of Padova, Padova, Italy; and King's College Hospital, London, United Kingdom.Search for more papers by this author and Alexander T. Cohen, MD, MBBS, MScFrom University of Padova, Padova, Italy; and King's College Hospital, London, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-7-201310010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In a multicenter randomized trial involving 786 patients having elective total hip replacement in Canada during a 3-year period, Anderson and colleagues (1) observed how, after 10 days of dalteparin therapy, 28 days of oral aspirin prophylaxis was noninferior to 28 days of dalteparin therapy for preventing venous thromboembolism (VTE). These results are very interesting to clinicians involved in elective hip surgery, particularly because some guidelines consider aspirin to be effective despite the single large randomized trial (2) quoted in the guidelines from the American College of Chest Physicians (3) that showed no effect of aspirin in ...References1. Anderson DR, Dunbar MJ, Bohm ER, Belzile E, Kahn SR, Zukor D, et al. Aspirin versus low-molecular-weight heparin for extended venous thromboembolism prophylaxis after total hip arthroplasty: a randomized trial. Ann Intern Med. 2013;158:800-6 LinkGoogle Scholar2. . Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet. 2000;355:1295-302. [PMID: 10776741] CrossrefMedlineGoogle Scholar3. Guyatt GH, Akl EA, Crowther M, Gutterman DD, and Schuünemann HJ; American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:7S-47S. [PMID: 22315257] CrossrefMedlineGoogle Scholar4. Hull RD, Pineo GF, Francis C, Bergqvist D, Fellenius C, Soderberg K, et al. Low-molecular-weight heparin prophylaxis using dalteparin extended out-of-hospital vs in-hospital warfarin/out-of-hospital placebo in hip arthroplasty patients: a double-blind, randomized comparison. North American Fragmin Trial Investigators. Arch Intern Med. 2000;160:2208-15. [PMID: 10904465] CrossrefMedlineGoogle Scholar5. Eriksson BI, Borris LC, Friedman RJ, Haas S, Huisman MV, Kakkar AK, et al. RECORD1 Study Group. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. N Engl J Med. 2008;358:2765-75. [PMID: 18579811] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Padova, Padova, Italy; and King's College Hospital, London, United Kingdom.Disclosures: Dr. Cohen: Support for travel to meetings for the study or other purposes and fees for participation in review activities such as data monitoring boards, statistical analysis, end point committees, and the like: Pfizer, Bristol-Myers Squibb; Board membership: Bayer, Bristol-Myers Squibb, Daiichi, Johnson & Johnson, Pfizer, Portola, Sanofi; Consultancy, payment for lectures including service on speakers bureaus, payment for development of educational presentations, travel/accommodations/meeting expenses unrelated to activities listed: Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi, GlaxoSmithKline, Johnson & Johnson, Mitsubishi Pharma, Pfizer, Portola, Sanofi, Schering-Plough, Takeda; Other: Astellas, AstraZeneca, Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi, GlaxoSmithKline, Johnson & Johnson, Mitsubishi Pharma, Pfizer, Portola, Sanofi-Aventis, Schering-Plough, Takeda, U.K. Government All-Party Working Group on Thrombosis, U.K. Thromboprophylaxis Forum. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAspirin Versus Low-Molecular-Weight Heparin for Extended Venous Thromboembolism Prophylaxis After Total Hip Arthroplasty David R. Anderson , Michael J. Dunbar , Eric R. Bohm , Etienne Belzile , Susan R. Kahn , David Zukor , William Fisher , Wade Gofton , Peter Gross , Stephane Pelet , Mark Crowther , Steven MacDonald , Paul Kim , Susan Pleasance , Nicki Davis , Pantelis Andreou , Philip Wells , Michael Kovacs , Marc A. Rodger , Tim Ramsay , Marc Carrier , and Pascal-Andre Vendittoli Aspirin Versus Low-Molecular-Weight Heparin After Total Hip Arthroplasty David R. Anderson , Michael J. Dunbar , and Susan R. Kahn Metrics October 1, 2013Volume 159, Issue 7Page: 502KeywordsAnticoagulantsArthroplastyDeep vein thrombosisHemorrhageHipMedical risk factorsOrthopedicsProphylaxisPulmonary embolismSurgeryThoraxTotal hip replacementVenous thromboembolism ePublished: 1 October 2013 Issue Published: October 1, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.019 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".