Comparable Efficacy of Two Anticoagulant Strategies Following Total Hip Replacement in Elderly Patients: A...

To compare the safety and efficacy of two different anticoagulation strategies of aspirin and low-molecular-weight heparin (LMWH) for the prevention of postoperative venous thromboembolism (VTE) in elderly patients undergoing total hip replacement (THR).

A randomised controlled study. Place and Duration of the Study: Department of Anaesthesiology, the South Campus of Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, between January 2021 and June 2025.

A total of 196 elderly patients were stratified into two cohorts: a combination therapy group (Group AL, n = 99) and a sequential therapy group (Group L, n = 97). Outcomes assessed included VTE incidence at 7 and 30 days postoperatively, intraoperative blood loss, intraoperative blood transfusion volume, and postoperative haemoglobin (Hb). Continuous variables between groups were compared using the t-test or the Mann-Whitney U test, and categorical variables were compared between groups using the chi-square test or Fisher's exact test.

At 30 days post-surgery, VTE incidence was lower in the combination group (16.1%) than in the sequential group (29.8%; p <0.05).

Concurrent administration of aspirin and LMWH may more effectively mitigate surgery-induced hypercoagulability, thereby reducing VTE incidence in elderly patients without increasing the risk of perioperative bleeding.

Elderly, Total hip replacement, Aspirin, Low molecular weight heparin, Venous thromboembolism, Postoperative.