Objective: To demonstrate the efficacy and safety of a multimodal stratified\napproach for prevention of thromboembolism in patients undergoing primary\ntotal hip arthroplasty. Method: A longitudinal retrospective clinical study\nof a cohort of 341 individuals undergoing total hip arthroplasty between\nMarch 2008 and July 2016. Of these, 242 patients met the criteria for inclusion\nin the study. Individuals with a history of deep vein thrombosis or pulmonary\nthromboembolism, thrombophilia, hypercoagulation conditions, and\nchronic users of anticoagulants before surgery received enoxaparin at a dose\nof 40 mg/day for 21 days. For the other group, acetylsalicylic acid was prescribed\nat a dose of 200 mg/day for 30 days. All patients had surgical risk assessed\nby the American Anesthesiology Association classified as I or II, and\nunderwent regional anesthesia, effective hydration, the same protocol of early\npostoperative rehabilitation, and the use of compression stockings. Drug cost\nanalysis was performed based on the BrasÃndice . To date, there are no publications\nin PubMed and Scielo on this subject regarding the Brazilian population.\nResults: The need for blood transfusion in the enoxaparin group was\nhigher and the overall complication and hemorrhagic rates were also significantly\nhigher (p < 0.010) in this group. Aspirin prescription costs 39 times\nless than enoxaparin. Conclusion: In patients without predisposing factors to\nthromboembolism and undergoing primary total hip arthroplasty, the multimodal\napproach with acetylsalicylic acid seems to be effective, with low cost\nand a low rate of complications.
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