Oğuzhan KORKMAZ, Ömer Serdar HAKYEMEZ, Niyazi ÇAKIR, Ardahan ÖZDENBOYACI, İbrahim UZUNLU, Abdullah DEMİRTAŞ, İbrahim AZBOY
Acta Orthopaedica et Traumatologica Turcica - 2026;60(2):1-6
Objective: The risk of symptomatic venous thromboembolism (VTE) following hip fracture surgery is estimated at 1%-6%, necessitating effective prophylactic measures. While aspirin has been widely used in total hip and knee arthroplasty due to its comparable efficacy, reduced bleeding risk, and cost-effectiveness, its role in trauma patients remains under-researched. This study aims to evaluate the efficacy and safety of aspirin and enoxaparin for VTE prophylaxis in hip fracture patients. Methods: This two-center, retrospective study analyzed 306 adult patients who underwent hip fracture surgery between 2019 and 2023. Patients were divided into 2 groups: the aspirin group (81 mg twice daily) and the enoxaparin group (40 mg subcutaneous once daily), both receiving prophylaxis for 4 weeks postoperatively. Results: The aspirin group (n = 136) and enoxaparin group (n = 170) had mean ages of 67.66 +/- 19.67 and 63.42 +/- 19.71 years, respectively. Hemoglobin decrease was significantly lower in the aspirin group (1.75 +/- 1.07 g/dL vs. 2.73 +/- 1.56 g/dL, P = .001). In addition, the amount of postoperative blood transfusion was statistically significantly lower in the aspirin group compared to in the enoxaparin group (0.89 vs. 1.31 units, respectively, P = .034). There was no significant difference in mean hospital stay (6.84 vs. 6.65 days, P = .751). The incidence of major bleeding was higher in the enoxaparin group (3.7% (n = 5) vs. 5.3% (n = 9)), though not statistically significant (P = .789). Symptomatic VTE occurred in 3.7% (n = 5) of the aspirin group and 5.3% (n = 9) of the enoxaparin group (P = .453). Conclusion: This study suggests that aspirin appears to be a reasonable alternative to enoxaparin for VTE prophylaxis in hip fracture patients, demonstrating comparable efficacy with a lower blood transfusion requirement and similar rates of major bleeding and symptomatic VTE.
