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Aspirin reduces the risk for DVT in critically ill mechanically ventilated patients
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MONTREAL — Current use of aspirin reduced the odds of deep venous thrombosis by more than 50% in a critically ill patient population who received mechanical ventilation, according to the results of a retrospective chart review presented at CHEST Annual Meeting 2015.
The researchers also found upper extremity deep venous thrombosis to be more common than lower extremity deep venous thrombosis — the opposite of what pulmonologists normally see, Muthiah Muthiah, MD, associate professor in the department of pulmonary, critical care, and sleep medicine at University of Tennessee Health Center, said after the presentation.
Ena Gupta, MD, MPH, an internal medicine resident at the University of Florida Jacksonville Healthcare Inc., and colleagues conducted a chart review of critically ill patients who received mechanical ventilation for more than 72 hours and who also underwent venous ultrasonography for suspected DVT between Jan. 2012 and Dec. 2013.
The analysis included 193 patients (mean age 58 years). DVT occurred in 25.4% of patients and 57% of cases occurred in the upper extremity.
Gupta and colleagues noted that DVT was identified in the first 15 days of hospitalization in 67.3% of patients.
After multivariable regression analysis, the use of aspirin demonstrated a 60% reduction in the odds of DVT (OR = 0.39; 95% CI, 0.16-0.94). Fifty three patients had already been on aspirin prior to hospitalization.
Gupta discussed what the next step should be in the research of aspirin for reducing the risk for DVT.
“We need [to conduct a] randomized, prospective trial to evaluate if aspirin can reduce the risk of DVT and [pulmonary embolism] and assess bleeding complication,” she said during the presentation. “We need to identify a target risk population that would have the most benefit and the least risk from the addition of aspirin for thromboprophylaxis in the critically ill population. Will other antiplatelet agents be less or more effective than aspirin — that remains to be seen. ” – by Ryan McDonald
Reference:
Gupta E, et al. Abstract 202634. Presented at: CHEST Annual Meeting 2015; Oct. 24-28; Montreal.
Disclosure: The researchers report no relevant financial disclosures.